UK Hand and Upper Limb Transplant Service, functional outcomes of the first six patients: A case series.

To date, three unilateral and seven bilateral hand and upper limb transplants have been performed by the UK Hand Transplant Programme. We report functional outcomes for our first six patients, who have been followed for between 4 and 10 years. All patients gained protective sensation to pain, pressure and temperature, and a recordable power grip. All patients saw an improvement in the Canadian Occupational Performance Measure performance and satisfaction scores, with five out of six patients improving the Disability of the Arm Shoulder and Hand scores. The Hand Transplant Score System graded all distal transplants as either a 'good' or 'excellent' with proximal transplants scoring 'fair' or 'good'. Hand transplant is an effective treatment in selected patients with continual improvements in function seen for up to 5 years.Level of evidence: IV.