Development of a Question Prompt Sheet for Upper Extremity Vascularized Composite Allotransplantation

J. Gacki-Smith¹, B. Kuramitsu¹, A. Ferzola², K. Vanterpool², C. Kunkle³, M. Hewitt³, A. Schultheis³, T. Riggleman³, J. Taylor³, C. Cooney², M. Levan², S. Tintle³, G. Brandacher², E. Gordon¹

¹Northwestern University, Chicago, IL, ²Johns Hopkins University, Baltimore, MD, ³Walter Reed National Military Medical Center, Bethesda, MD

Meeting: 2021 American Transplant Congress

Abstract number: 708

Keywords: Ethics, Patient education, Psychosocial

Topic: Clinical Science » Ethics » Psychosocial and Treatment Adherence

Session Information

Session Name: Psychosocial and Treatment Adherence

Session Type: Poster Abstract

Session Date & Time: None. Available on demand.

Location: Virtual

*Purpose: Upper extremity (UE) vascularized composite allotransplantation (VCA) is an innovative option for people with UE amputations. Individuals with limb loss commonly receive little information about treatment options and have limited communication with healthcare providers about their condition. Making informed treatment decisions can be difficult when information needs are unmet. Question prompt sheets (QPS) are structured lists of questions that can facilitate communication with providers by empowering patients to ask questions and acquire relevant information. No QPS is available for VCA. This study aimed to develop an UE VCA-specific QPS.

*Methods: We conducted in-depth interviews among people with acquired UE amputations. Participants were asked about information needs about UE VCA to inform the initial QPS draft. A qualitative thematic approach was used to analyze open-ended responses. The multidisciplinary research team reviewed the QPS draft to improve organization, clarify question wording, and remove repetitive items.

*Results: Thus far, 12 individuals completed an in-depth interview (75% participation rate). Most were male (71%), with a mean age of 49 years, and had a unilateral amputation (75%). Most participants (75%) reported being ‘completely’ or ‘a lot’ likely to use a QPS if they were considering UE VCA. The initial QPS draft included 77 items grouped into 16 topics. UE VCA topics and sample questions included: Eligibility (What makes a good candidate?); Matching (How does the donor matching process work?); Surgery (How is the hand or arm surgically connected to my body?); Function (How much hand function can I regain?); Risks (What happens if my body rejects the hand/arm? Is it removed?); Appearance (Will the new hand look noticeably different from my arm?); and Rehabilitation (What does rehabilitation involve?).

*Conclusions: Preliminary findings suggest people with UE amputations desire information about VCA. The UE VCA-QPS draft will be refined via semi-structured interviews and team review for content validity, comprehensiveness, and readability. Future research should assess the impact of the UE VCA-QPS on communication and informed decision making about UE VCA.

To cite this abstract in AMA style:

Gacki-Smith J, Kuramitsu B, Ferzola A, Vanterpool K, Kunkle C, Hewitt M, Schultheis A, Riggleman T, Taylor J, Cooney C, Levan M, Tintle S, Brandacher G, Gordon E. Development of a Question Prompt Sheet for Upper Extremity Vascularized Composite Allotransplantation [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/development-of-a-question-prompt-sheet-for-upper-extremity-vascularized-composite-allotransplantation/. Accessed May 11, 2025.

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