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SAGE Open Med. 2019 Jun 12;7:2050312119858248. doi: 10.1177/2050312119858248. eCollection 2019.

Adjustment to amputation and interest in upper limb transplantation.

Author information

Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.



Upper limb transplantation provides a new restorative option for individuals with amputations. As true for most operations, patient selection is critical to optimizing transplantation outcomes. To improve on the patient selection process, we used qualitative methods to better understand the issues regarding upper extremity loss as well as upper limb transplantation from the amputee point of view.


Individuals with upper limb amputations (age range = 24-73 years) discussed their adjustment following amputation and their interest toward transplantation in either a focus group (n = 5) or semi-structured interview (n = 17). Transcripts were coded by theme and summarized.


Participants described a year-long process typified by adjustment to a new role as an amputee, both psychosocially and functionally. We found that the extent of adjustment was inversely related to an interest in transplantation.


These findings could explain the difficulty in identifying "ideal" candidates for upper extremity transplantation and may have implications for patient selection and counseling.

Level of Evidence:

Prognostic Study, Level V.


Upper extremity; psychosocial; vascularized composite allotransplantation

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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