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Hand Transplant Research

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Scientific & Lay Presentations

Scientific Publications

Overview Articles (Hand Transplantation)

Our Work:


Barker, JH., Francois, CG., Frank, JM., Maldonado, C.  Composite tissue allotransplantation (CTA): Present state and future outlook. Transplantation, 73(5): 832-35, 2002.

Vossen, M., Molfese, DL., Fonaryova-Key, A., Kelly, S., Maldonado, C., Kon, M., Barker, JH. Brain plasticity following hand transplantation. European Surgical Research. 34(S1): 4, 2002 (ABSTRACT).

Barker, JH., Breidenbach,, W., Hewitt, CW. Proceedings of the 2nd International Symposium on Composite Tissue Allotranplantation: Special Issue (Invited Section Editor) Microsurgery, 20(8): 2000.

Francois, C., Breidenbach, WC., Maldonado, C., Kakoulidis, T., Dubernard, J., Pei, G., Ren, X., Barker, JH. Hand transplantation: comparisons and observations of the first four clinical cases. Microsurgery, 20(8): 360-371, 2000.

Gorantla, V., Maldonado, C., Frank, J., Barker, JH. Composite tissue allotransplantation (CTA): Current Status and Future Insights” European J Trauma, 7 (6): 267-274, 2000

Jones, JW., Gruber, SA., Barker, JH., Breidenbach, WC. Successful hand transplantation: One-year follow-up. New England Journal of Medicine, 343(7): 468-473, 2000.

Barker, JH., Jones, JW., Breidenbach, WC. Composite Tissue Transplantation; A Clinical Reality? Transplantation Proceedings, (Invited Editor), 30(6): 2686-2787, 1998.


Related Work of Others:


Jones, JW., Gruber, SA., Barker, JH., Breidenbach, WC.  Successful hand transplantation—one-year follow-up.  New England Journal of Medicine, 2000; 343: 468-73.

Dubernard , JM., Owen, E., Herzberg, G., et. al.  The first transplantation of a hand in humans.  Early results.  Chirurgie, 1999, 124: 358-65. 

Dubernard, JM., Owen, E., Herzberg, G., et. al. Human hand allograft: report on first 6 months. Lancet 1999; 353: 1315-20.

Jean-Michel Dubenard, Earl Owen, Guillaume Herzberg, Marco Lanzetta, Xavier Martin, Hari Kapila, Marwan Dawahra, Nadey S. Hakim.  Human hand allograft: report on first 6 months.   The Lancet,  353: 1315-1320, April 1999.

Birchall, MA.,  Human laryngeal allograft: shift of emphasis in transplantation. Lancet, 1998; 351: 539-40. 

Hofmann, GO., Kirschner, MH., Wagner, FD., Brauns, L., Gonschorek, O., Buhren, V.  Allogeneic vascularized grafting of human knee joints under postoperative immunosuppression of the recipient.  World J Surg 1998; 22: 818-23. 

Black KS, Hewit, CW.  Report: Composite Tissue Transplantation Workshop. Department of Veterans Affairs, Rehabilitation Research and Development Service, Washington, DC, 1991. 

Egerszegi, EP., Samulack, DD., Daniel, RK.  Experimental models in primates for reconstructive surgery utilizing tissue transplants.  Annals of Plastic Surgery, 1984; 13: 423-30. 

Kahan, BD.  Cosmas and Damien revisited.  Transplant Proc, 1983; 15: 2211-6. 

Black, KS., Hewitt, CW,, Fraser, LA., et. al.  Cosmas and Damien in the laboratory.  N Engl J Med, 1982; 306: 368-9. 

Siliski, JM., Green, CJ.  More on Cosmas and Damien.  N Engl J Med, 1982; 309: 1642. 

Chen, ZW., Meyer, VE., Kleinert, HE., Beasley, RW.  Present indications and contraindications for replantation as reflected by long-term functional results.  Orthop Clin North Am, 1981; 12849-70. 

Anon.  Hand transplanted from cadaver is reamputated. Med Trib Med News, 1964; 5: 23.

Gilbert, R.,  Transplant is successful with a cadaver forearm.  Med Trib Med News,  1964; 5: 20.

Malt, RA., McKhann, CF.  Replantation of severed arms.  JAMA,  1964; 189: 716-22.

Da Varagine, J., Leggenda, Aurea.  Libreria Editrice Fiorentina, 1952, pp 648-52.

Hall, RH.,  Whole upper extremity transplant for human beings: general plans of procedure and operative technique.  Ann Surg, 1944; 120: 12.

Gibson, T., Medawar, PB.  Fate of skin homografts in man. i, 1943; 77: 299.

Guthrie, CC.,  Applications of blood vessels surgery.  In: Blood Vessel Surgery,  New York, NY.  Longman Green, 1912, pp 37-42.

Carrel, A.  Results of the transplantation of blood vessels, organs, and limbs.  JAMA, 1908, 51: 1662.



Immunological (Hand Transplantation)


Our Work:

Vossen, M., Edelstein, J., Majzoub, R., Zdichavasky, M., Maldonado, C., Ray, M., Perez-Abadia, GA., Jevans, A., Barker, JH. The effect Cyclosporine A has on bone healing in a porcine composite tissue allograft model.  Plast Reconstr Surg,(IN PRESS); (2004).

Fernandez-Botran, R., Gorantla, V., Sun, X., Ren, X., Perez-Abadia, G., Maldonado, C., Ray, M., Barker, JH. Targeting of glycosaminoglycan-cytokine interactions as a novel therapeutic approach in allotransplantation Transplantation, 74(5): 623-9, 2002.

J. Edelstein, J.W. Jones, X. Ren, T. Ustuner, M. Zdichavsky, G. Perez-Abadia, D.K. Granger, A.W. Jevans, C. Maldonado, W. Breidenbach, J.H. Barker and S.A. Gruber.  Donor/Recipient skin and whole-blood cyclosporine A levels in a swine composite tissue allograft model: Correlation and relationship to rejection. Transplantation Proceedings, 34: 1315-19, 2002.

Gorantla, VS., Perez-Abadia, G., Ren, X., Majzoub, R., Prabhune, KA., Francois, CG., Vossen, M., Brouha, PC., Maldonado, C., Pidwell, DJ., Breidenbach, WC., Granger, DK., Barker, JH. A clinically feasible protocol to induce tolerance to limb allografts using mixed allogeneic chimerism. (ABSTRACT) Abstract #781, Am J Transplant, 1(1): 321, 2001.

Gorantla, VS., Barker, JH., Jones, JW,, Prabhune, KA., Maldonado, C., Granger, DK. Immunosuppressive agents used in transplantation: mechanisms of action, adverse effects and current anti-rejection strategies. Microsurgery, 20(8): 420-429, 2000.

Gorantla, VS., Perez-Abadia, G., Prabhune, K., Orhun, H., Kakoulidis, T., Majzoub, R., Maldonado, C., Anderson, GL., Ogden, L., Breidenbach, WC., Ildstad, S., Barker, JH. Composite tissue allograft (CTA): tolerance induction without graft vs host disease (GvHD). Surgical Forum, 51: 578-79, 2000.

Gruber, SA., Shirbacheh, MV., Jones, JW., Barker, JH, Breidenbach, W. Local drug delivery to composite tissue allografts. Microsurgery, 20(8): 407-411, 2000.

Orhun, H., Perez-Abadia, G., Gorantla, V.,  Voor, M., Tseng, M., Maldonado, C., Andersol, GL., Ogden, L., Breidenbach, WC., Barker, JH. Elastic Properties of Bone in Composite Tissue Allotransplantation: the rat hind limb model. Surg Forum, 51: 463-65, 2000.

Prabhune, KA., Gorantla, VS., Maldonado, C., Barker, JH., Ildstad ST. Mixed allergenic chimeras and tolerance to composite tissue allografts.  Microsurgery, 20(8): 441-447, 2000.

Edelstein, J., Tecimer, T., Ustuner, T., Zdichavsky, M., Shirbacheh, M., Maldonado, C., Breidenbach, WC., Ray, MB., Jones, JW., Barker, JH. The effect of tacrolimus based combination therapy on muscle and bone rejection in a pre-clinical composite tissue allograft model.  Transplantation, 67(7): 212, 1999. (ABSTRACT). 

Jones, JW., Ustuner, T., Zdichavsky, M., Edelstein, J., Ren, S., Maldonado, C., Ray, M., Jevans, AW., Breidenbach, WC., Gruber, SA., Barker, JH. Long-term survival of an extremity composite tissue allograft with FK506-mycophenolate mofetil therapy. Surgery, 126(3): 384-388, 1999. 

Tecimer, T., Edelstein, J., Shirbacheh, M., Ustuner, T., Zdichavsky, M., Maldonado, C., Breidenbach, WC., Ray, MB., Jones, JW., Barker, JH. The effect of cyclosporine A based combination therapy on bone, muscle and tendon rejection in a composite tissue allograft (CTA) model. Transplantation, 67(7): 211, 1999. (ABSTRACT). 

Zdichavsky M., Jones, J., Ustuner, TE., Ren, XJ., Maldonado, C., Breidenbach, W., Gruber, SA,. Ray, M., and Barker, JH. Scoring of skin rejection in a swine composite tissue allograft model. J Surgical Research, 85:1-8, 1999.

Zdichavsky, M., Ustuner, T., Jones, JW., Edelstein, J., Breidenbach, W., Jevans, A., Maldonado, C., Barker, JH. Cyclosporin A combination therapy prolongs composite tissue allograft survival in a swine model. Euro J Surg. Res: 31(Suppl. 1): 34-35 (No. 58) 1999. (ABSTRACT)

Shirbacheh, MV., Jones JW., Breidenbach, WC., McCabe, SJ., Barker, JH., Gruber, SA.  The case for local immunosuppressant in composite tissue allotransplantation. Transplantation Proceedings, 30(6): 2739-42, 1998. 




Related Work of Others:


Wendt, JR., Ulich, T., and Rao, PN. Long-Term Survival of Human Skin Allografts in Patients with Immunosuppression Plastic Reconstructive Surgery,  2004; 113(5): 1347-54.

Kanitakis, J., Jullien, D., Petruzzo, P., Hakim, N., Claudy, A., Revilard. JP., et al. Clinic pathologic features of graft rejection of the first human hand allograft. Transplantation, 2003; 76: 688-693.

Daoud, AJ., et, al. A comparison of the safety and efficacy of mycophenolate mofetil, prednisone and cyclosporine and mycophenolate mofetil, and prednisone and tacrolimus. Transplantation Proceedings, 1998; 30: 4079-81.

Foster, FD., Fan, L., Neipp, M., et, al.  Donor-specific tolerance induction in composite tissue allografts.  Am J Surg, 1998; 176: 418-21.

Lee, WPA., Rubin, JP., Cober, S., Ierino, F., Randolph, MA., Sachs, DH.  Use of swine model in transplantation of vascularized skeletal tissue allografts.  Transplant Proc, 1998; 30: 2743-5.

Stratta RJ et al for the FK/MMF Multi-Center Study Group. Simultaneous use of tacrolimus and mycophenolate mofetil in combined pancreas-kidney transplant recipients: a multi-center report. Transplantation Proceedings, 1997; 29: 654-55.

Lee, WPA., Pan, YC., Kesmarky. S,, et al.  Experimental orthotropic transplantation of vascularized skeletal allografts: functional assessment and long-term survival. Plast Reconstr Surg, 1995; 95: 336-349. 

Benhaim, P., Anthony, JP., Lin, LYT., McCalmont, TH., Mathes, SJ.  A long-term study of allogeneic rat hindlimb transplants immunosuppressed with RS-61443. Transplantation, 1993; 56: 911-7

Hovius, SE., Stevens, HP., van Nierop, PW., et al. Allogeneic transplantation of the radial side of the hand in the rhesus monkey: I. Technical aspects. Plast Reconstr Surg, 1992; 89: 700-9.

Hewitt, CW., Ramsamooj, R., Patel, MP., Yazdi, B., Achauer, BM., Black, KS.  Development of stable mixed T cell chimerism and transplantation tolerance without immune modulation in recipients of vascularized bone marrow allografts. Transplantation, 1990; 50: 766-72.

Arai, K., Hotokebuchi, T., Miyahara, H., et, al.  Limb allografts in rats immunosuppressed with FK506: I. Reversal of rejection and indefinite survival. Transplantation, 1989; 48: 782-6. 

Stark, GB., Swartz, WM., Narayanan, K., and Moller, AR.  Hand transplantation in baboons. Transplant Proc, 1987; 19: 3968-71.

Daniel, RK., Egerszegi, EP., Samulack, DD., et. al.  Tissue transplants in primates for upper extremity reconstruction:  a preliminary report.  Journal of Hand Surgery (Am), 1986; 11: 1-8.

Hewitt, CW., Black, KS., Dowdy, SF., et. al.  Composite tissue (limb) allografts in rats. III. Development of donor-host lymphoid chimeras in long-term survivors. Transplantation 1986; 41: 39-43. 

Black, KS., Hewitt, CW., Fraser, LA., et. al.  Composite tissue (limb) allografts in rats. II. Indefinite survival using low-dose cyclosporine. Transplantation, 1985; 39: 365-8.

Hewitt, CW., Black, KS., Fraser, LA., et, al.   Composite tissue (limb) allografts in rats. I. Dose-dependent increase in survival with cyclosporine. Transplantation, 1985; 39: 360-4. 

Siliski, JM., Simkin, S., Green, CJ.  Vascularized whole knee joint allografts in rabbits immunosuppressed by cyclosporin A. Arch Orthop Trauma Surg, 1984; 103 26-35. 

Furnas, DW., Black, KS., Hewitt, CW., Fraser, LA., Achauer, BM.  Cyclosporine and long-term survival of composite tissue allografts (limb transplants) in rats (with historical notes on the role of plastic surgeons in allotransplantation).  Transplant Proc, 1983; 15: 3063-8. 

Doi, K.  Homotransplantation of limbs in rats. Plast Reconstr Surg, 1979; 64; 613-21. 

Poole, M., Bowen, JE., Batchelor, JR.  Prolonged survival of rat leg allografts due to immunological enhancement. Transplantation, 1976; 22: 108-11. 

Lapchinsky, AG., Eingorn, AG., Uratkov, EF.  Homotransplantations of extremities in tolerant dogs observed up to seven years.  Transplant Proc, 1973; 5: 773-9. 

Lance, EM., Inglis, AE., Figarola, F., Veith, RJ.  Transplantation of the canine hind limb.  J Bone Joint Surg, 1971; 53A: 1137-49. 

Goldwyn, RM., Beach, PM., Feldman, D., Wilson, RE.  Canine limb homotransplantation. Plast Reconstr Surg ,1966; 37: 184-95. 

Schwind, JV.  Homotransplantations of extremities by parabiosis.  Ann NY Acad Sci, 1962; 99: 933. 

Schwind, JV.  Successful transplantation of a leg in albino rats with reestablishment of muscular control.  Science, 1936; 84: 355. 




Lay Publications

Altman, LK.  Both hands and forearms transplanted for first time.  New York Times, January 15, 2000.

Franken Science push back the frontiers of medicine. London Sunday Times Magazine, February 6, 2000, pp 43-56. 

New direction for transplants raises hopes and questions. New York Times, May 2, 1999.

Cutting Edge Transplants. Popular Science, October, 1999, pp 62-67

Medical innovation close at hand. American Medical News, September 14, 1998, p.1. 

Surgeons in France try hand transplant. New York Times, September 25, 1998.

Doctors who transplanted hand ponder their surprising patient. New York Times, October 6, 1998, p. B11

Frankenstein moving from fiction to fact. The Globe and Mail, November 5, 1998. 

Hand surgeons decry French transplant as much too risky. Physician’s Weekly, November 8, 1998, p.1. 




Scientific and Lay Presentations

Our Work:


Vossen, M., Molfese DL., Fonaryova-Key A., Kelly S., Maldonado C., Kon, M., Barker, JH. Brain. plasticity following hand transplantation. Annual Meeting of the Society for University Surgeons, Houston, TX. February 2003

Banis, JC., Brouha, PCR., Majzoub, R., Stadelmann, WK., Cunningham, M., Maldonado, C., Kon, M., Barker JH. How much risk are individuals willing to accept to receive composite tissue allotransplantation reconstructive procedures? Annual Meeting of the American Association of Plastic Surgery, April 2002, Seattle, Washington.

Barker, JH. “Composite tissue allotransplantation for reconstructing complex tissue defects: On the frontier of reconstructive surgery” Klinikum der Johann Wolfgang Goethe-Universitat Frankfurt am Main, Aspekte der Rekonstruktiven und Plastischen Chirurgie nach Verletzungen. Frankfurt, Germany April 24th 2002.

Barker, JH. “Composite tissue allotransplantation research collaboration between the Universities of Louisville and Utrecht” Grand Rounds, University Hospital, Utrecht, The Netherlands. April 22nd 2002.

Barker, JH. “Past and Future Research; the foundation for clinical composite tissue allotransplantation”. Annual meeting of the Dutch Society of Hand, Reconstructive and Aesthetic Surgery, Belhaven, NL, 4-5-2002.

Hand transplantation, the future is here Radio Health Journal, Aired the week of October 20, 2002.

Vossen, M., Molfese, DL., Fonaryova-Key, A., Kelly, S., Maldonado, C., Kon, M., Barker, JH. Brain plasticity following hand transplantation. 37th Congress of the European Society for Surgical Research, Szeged, Hungary. 23-25 May 2002

Vossen, M., Molfese DL., Fonaryova-Key, A., Maldonado, C., Kon, M., Barker, JH. Cortical reorganization following hand transplantation. 13th Annual meeting of the European Association of Plastic Surgeons, Crete, Greece. 30 May-1 June 2002

Orhun, H., Gorantla, V., Voor, M., Breidenbach, W., Barker, JH. Elastic properties of bone in composite tissue allografts. 8th Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), Istanbul, Turkey, June 10-14, 2001.

Barker, JH. Animal research leading to the nation’s first human hand transplant. 2nd International Symposium on Composite Tissue Allograft. Louisville, KY, May 18-19, 2000

Barker, J., Breidenbach, W., Jones, J., Shirbacheh, MV. Potential benefit of local immunotherapy in hand transplantation. 54th Annual Meeting of the American Society for Surgery of the Hand, Boston, MA, September 2-4, 1999.

Jones, JW., Breidenbach, WC., Barker, JH., Gruber, SA. From bench to bedside: porcine extremity composite tissue allograft (CTA) to human hand transplant. American Society of Transplantation Surgeons, 18th annual Meeting, Chicago IL, May 15-19, 1999.

Jones, JW., Zdichavsky, M., Ustuner, ET., Ren, XP., Edelstein, J., Maldonado, C., Jevans, A., Ray, M., Breidenbach, WC., Barker, JH., Gruber, SA. Dep. Long-term composite tissue allograft (CTA) survival in a pig model with FK506 (FK/mycophenolate mofetil (MMF) Therapy. 60th Annual Meeting of the Society of University Surgeons, New Orleans, LA, February 11-13, 1999.

Zdichavsky, M., Jones, JW., Ustuner, T., Ren, X., Edelstein, J., Maldonado, C., Breidenbach, W., Barker, JH., Ray M. Assessment of skin rejection in composite tissue allografts (CTA) by a histological grading system in a swine model. United States and Canadian Academy of Pathology, Inc., (USCAP) Annual Meeting,  San  Francisco, CA,  March 20-26, 1999.

Zdichavsky, M., Ustuner, T., Jones, JW., Edelstein, J., Breidenbach, W., Jevans, A., Maldonado, C., Barker, JH. Cyclosporine A combination therapy prolongs composite tissue allograft survival in a swine model. 34th Congress of the European Society of Surgical Research (ESSR), Bern, Switzerland, April 22-24, 1999.

A chat with a hand surgeon. CNN Health Chat line, January 29, 1998.

Ren, X., Zdichavsky, M., Ustuner, ET., Harralson, TG., Jones, JW., Breidenbach, WC. Marz,i I., Maldonado, C., Barker, JH. Radial forelimb osteomyocutaneous flap as a composite tissue allotransplant model in swine.  Plastic Surgery Research Council Annual Meeting, Loma Linda, CA, April 4-7, 1998.

Rodocker, G., McCabe, SJ., Breidenbach, WC., Barker, JH., et al. Evaluating the feasibility of upper extremity transplantation using decision analysis. Seventh IFSSH Congress, Vancouver, BC, May 24-28, 1998.

Shirbacheh, S., Breidenbach, WC., Barker, JH. The feasibility of human hand transplantation. Seventh IFSSH Congress, Vancouver, BC, May 24-28, 1998.

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