t T

surgeons, transplantation specialists, physicians dissected as far proximally as possible in order to and immunologists participated. In addition, the med-ical-surgical team at Innsbruck University Hospital which actually carried out the procedure discussed possible improvements in quality of life after transplan-tation and the potential risks associated with life-long immunosuppression (Doi et al., 1989). They concluded that allograft hand transplantation is justifiable. The potential hand transplant recipient was admitted to the Innsbruck University Hospital in June 1999 for routine pre-transplantation investigations which in-cluded laboratory studies, determination of blood group and human leukocyte antigen (HLA) type, tests for obtain sufficiently long tendons for transplantation. The anatomical structures to be microsurgically joined were sequentially prepared and tagged, from palmar to dorsal. The tourniquet on the donor’s upper arm was removed after careful haemostasis with bipolar coagulation. The brachial artery was then dissected 3 cm above the elbow joint and cannulated: after tendon dissection, the limb was irrigated with 500ml of University of Wisconsin (UW) organ preservation solution at 41. With the forearm in neutral rotation, an osteotomy was performed in the middle third, so that sufficient length of the forearm bones was available for theDOUBLE HAND TRANSP