Reconstructive Vascularized Composite Allotransplantation: Qualitative Approach to Enhance Patient Reported Outcome Metrics and the Candidate Screening Process
Technical Report,30 Sep 2018,29 Sep 2019
The Trustees of the University of Pennsylvania Philadelphia United States
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Hand transplantation also known as Vascularized Composite Allotransplantation, or VCA can potentially restore function and improve quality of life QOL for affected individuals. Over the last two decades, science has focused on improving this treatment, and people are finding more success with this surgery. However, the science is less clear on who are the best candidates for this type of surgery. Also, so far doctors have focused mostly on the medical parts of the surgery but have focused less on how recipients feel about their QOL with their new hands. VCA is very different from solid organ transplantation e.g., kidney transplant. Patients who want hand transplants must be resilient, highly motivated, and determined to succeed in ways that are not required of solid organ transplant recipients. Psychological evaluation before the surgery is important, but scientists do not yet know the most important questions to ask patients. The proposed research intends to take what we know from studying amputees and other organ transplant patients to study people who receive hand transplants. This will also help doctors know what makes someone a good candidate for hand transplantation. The purpose of this project is to understand QOL before and after hand transplant, and to understand what factors make someone a good candidate for this surgery. This project addresses the FY17 Reconstructive Transplant Research Program RTRP Qualitative Research Award Focus Area Psychosocial considerations and challenges associated with VCA. To date, we have conducted 10 focus groups with VCA stakeholders from a wide variety of specialties and backgrounds. Preliminary results indicate that VCA QOL issues are similar to those reported in other trauma-related clinical groups, such as resilience, depression, anxiety, body image, social isolation, stigma, and participation. Several topics mentioned were unique to the hand transplant patient experience, such as sense of wholeness.
- Medicine and Medical Research