Bilateral hand transplantation: result at 20 months.

On November 2006, a bilateral hand allotransplantation was performed for a 47-year-old female who had suffered radiocarpal amputations 28 years before. Technical aspects of the operation are detailed. Alemtuzumab induction, and triple therapy of tacrolimus, mycophenolate mofetil and prednisone were used to control rejection. The evolution of the result and functioning at 20 months are presented in detail. Two acute rejection episodes occurred and were successfully treated with steroids. In addition the patient developed a factitious visual disorder and a facial basal cell carcinoma. Functionally, at 20 months, the patient had a Hand Registry Functional Score of 69 (good), and a DASH score of 19.