2598: Experience with patient referrals for upper extremity transplantation at a US academic medical center

Abstract

2598: Experience with patient referrals for upper extremity transplantation at a US academic medical center Harriet Kiwanuka, Mario A. Aycart, MD, Ericka M. Bueno, Bohdan Pomahac, MD, and Simon G. Talbot, MD Brigham and Women’s Hospital, Boston, MA, USA Introduction To date, there have been over 100 upper extremity transplantations (UET) performed in 71 patients worldwide, with 3 bilateral transplants performed at our institution. Despite the growing number of procedures, there are little data regarding institutional screening practices or description of the population of patients that seek transplantation as a treatment modality for their upper extremity disabilities. In an attempt to better understand our institution’s referral patterns and identify factors that may be associated with successful screening, we performed a systematic review of our experience to date. Methods Contact demographic and injury characteristics were retrospectively reviewed from 2010 through 2015. We investigated the relationship between referral source (physician vs. self) with the contact’s demographic characteristics (age, gender, race, mechanism of injury, geographic location) and clinical trial status (e.g., accepted, excluded, transplanted). Results There were a total of 89UET contacts. The average age was 35.2 years, with most contacts beingWhite (nD 24). The majority were male (n D 67, 75.3%) and the most common indication for referral was trauma (n D 43, 55.8%). The majority of our contacts resided within the US (n D 55, 67.9%). Of the 89 contacts, 20 (22.5%) were physician referrals and 69 (77.5%) were self referrals. Physician referrals led to the most screened and transplanted contacts, whereas self-referral often led to immediate exclusion. Conclusions In this study, we provide a comprehensive overview of our center’s experience with patients interested in UET along with their demographic and injury characteristics and mode of referral. We also present a description of the clinical status of our 89 contacts, and illustrate the impact that mode of referral has had on successful screening and subsequent transplantation in our clinical trial. Figure 1. Overall clinical status of contacts. CONTACT Harriet Kiwanuka hkiwanuka@partners.org © 2016 Harriet Kiwanuka, Mario A. Aycart, Ericka M. Bueno, Bohdan Pomahac, and Simon G. Talbot. Published with license by Taylor & Francis. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The moral rights of the named author(s) have been asserted. VASCULARIZED COMPOSITE ALLOTRANSPLANTATION 2016, VOL. 3, NOS. 1–2, 11 http://dx.doi.org/10.1080/23723505.2016.1234211