In July 2014, the OPTN assumed responsibility for developing policy for vascularized composite allotransplantation (VCA). This abstract presents initial data collected in upper limb transplantation after the OPTN implemented oversight of VCA in the US.

The OPTN/UNOS VCA Committee developed data collection requirements for VCA. These requirements, to the extent possible, followed guidelines similar to solid organ transplants.

As of November 10, 2017, a total of 10 people have received limb transplantation since July 2014. Of these, 6 recipients received bilateral limb transplants and 4 received unilateral limb transplants. The mechanism of injury was trauma for 5 recipients and infection for the remaining five. Eight were male and 2 were female. One recipient was <18 yrs old, 5 were aged 18-44, 2 were aged 45-54, and 2 were >55 yrs old. Eight recipients were white, 1 was black, and 1 was Hispanic.

Follow-up time ranged from 1 week to 3.1 yrs (median=1.34 years; IQR: 1.15-2.40). All 10 recipients were alive and 9 recipients had viable grafts as of November 10, 2017. One was reported with a graft loss (unilateral) at five days post-transplant.

Of the 6 recipients with complete reported complication data (n=2 missing, 1 not yet due, and 1 NA because of early graft loss), none experienced new onset diabetes or metabolic complications. Two recipients experienced infectious complications, and four recipients experienced at least one acute rejection episode.

The OPTN is currently collecting data on upper limb transplants before July 2014. There have been 32 recipients reported since 1999. Of these, 5 underwent amputation due to graft loss, and 1 death was reported unrelated to transplant. An update will be reported in June 2018.

CITATION INFORMATION: Wainright J., Levin L., Wholley C., Cherikh W., Klassen D., Cendales L. Upper Limb Transplantation in the US: An Early Look at OPTN Data Am J Transplant. 2017;17 (suppl 3).

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