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Bone Healing After Secondary Surgery on Hand Allografts Under Sirolimus-Based Maintenance Immunosuppression

Cavadas, Pedro C. MD, PhD*; Hernan, Izaro MD; Landin, Luis MD*; Thione, Alessandro MD, PhD*

doi: 10.1097/SAP.0b013e318212686b
Transplantation Surgery and Research

Composite tissue allograft transplantation is a recognized option for reconstruction in upper limb amputees. Sirolimus is an immunosuppressive drug that prevents organ rejection and improves kidney function, but its use has been associated with impaired healing. Two recipients of bilateral hand allografts underwent arthrodeses of 6 joints as secondary procedures while being treated with sirolimus. We found no clinical or radiologic evidence of bone healing delay or bone nonunion. The functional evaluation revealed an improvement in the performance of activities of daily living after the transplant and secondary procedures. We conclude that bone surgery can be performed safely in recipients of hand allografts who are receiving sirolimus-based immunosuppressive therapy.

From the *Transplant Surgery Division, University Hospital “La Fe,” Valencia, Spain; and †Clinica Cavadas, Pedro Cavadas Foundation, Valencia, Spain.

Received November 17, 2010, and accepted for publication, after revision, January 25, 2011.

Reprints: Luis Landin, MD, Clinica Cavadas, Paseo de Facultades 1, bajo 8, 46021 Valencia, Spain. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.