{"id":1920,"date":"2021-07-14T12:30:51","date_gmt":"2021-07-14T02:30:51","guid":{"rendered":"https:\/\/blogs.rch.org.au\/grandrounds\/?p=1920"},"modified":"2021-07-27T17:49:12","modified_gmt":"2021-07-27T07:49:12","slug":"paediatric-upper-limb-transplantation-a-new-frontier-of-surgery-immunology-and-ethics","status":"publish","type":"post","link":"https:\/\/blogs.rch.org.au\/grandrounds\/2021\/07\/14\/paediatric-upper-limb-transplantation-a-new-frontier-of-surgery-immunology-and-ethics\/","title":{"rendered":"Paediatric upper limb transplantation: A new frontier of surgery, immunology, and ethics"},"content":{"rendered":"<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/579625489?dnt=1&amp;app_id=122963\" width=\"1140\" height=\"641\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<p><strong>Synopsis<\/strong><\/p>\n<p>Hand transplantation is a technique to reconstruct absent and functionless upper limbs using cadaveric donor limbs.<\/p>\n<p>In the 20 years since the world\u2019s first hand transplant, the technique has developed into a reliable and valuable option for\u00a0carefully\u00a0selected adult amputees.\u00a0The downside\u00a0is the need for immunosuppression with its inherent risks (metabolic,\u00a0infective, neoplastic, and\u00a0renal impairment) for the duration of the transplant.<\/p>\n<p>This grand round presentation will\u00a0summarise the international experience with adult hand transplantation to date, discuss\u00a0key\u00a0principles for this form of transplant,\u00a0and critically evaluate whether this technique can and should be applied to\u00a0children. Open\u00a0audience discussion will be invited on ethical challenges raised by the prospect of offering hand transplants\u00a0to children.\u00a0These challenges\u00a0include the comparative benefits and risks for children specifically, and questions of whether\u00a0this is something that parents could validly\u00a0consent to for a child.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Speakers<\/strong><\/p>\n<p><strong>Dr Daniel Wilks<\/strong> recently relocated from Leeds, UK to work fulltime as a consultant plastic surgeon at The Royal Children&#8217;s Hospital.<\/p>\n<p>In Leeds, Dan worked as a consultant plastic surgeon and some 10 years ago, began exploring the possibility of offering hand transplantation in the UK. After extensive planning and consultation, the Leeds-based programme was approved as the sole UK provider by NHS England. Between 2012 and 2019, the UK team, with Dan as one of the lead surgeons, transplanted 10 limbs in 6 patients \u2013 currently one of the largest cohorts in the world. Dan\u2019s other areas of interest are children\u2019s hand surgery, nerve surgery, and microsurgery.<\/p>\n<p><strong>Professor Lynn Gillam<\/strong> is a clinical ethicist at RCH, and Academic Director of the Children\u2019s Bioethics Centre.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Hand transplantation is a technique to reconstruct absent and functionless upper limbs using cadaveric donor limbs.<\/p>\n<p>In the 20 years since the world\u2019s first hand transplant, the technique has developed into a reliable and valuable option for\u00a0carefully\u00a0selected adult amputees.\u00a0The downside\u00a0is the need for immunosuppression with its inherent risks (metabolic,\u00a0infective, neoplastic, and\u00a0renal impairment) for the duration of the transplant.<\/p>\n","protected":false},"author":97,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[466,12674,7930,7949,7944,5065,12683,12664,5658],"tags":[],"class_list":["post-1920","post","type-post","status-publish","format-standard","hentry","category-clinical","category-ethics","category-general-interest","category-paediatrics","category-plastic-surgery","category-rch","category-rehabilitation","category-surgery","category-video"],"acf":[],"_links":{"self":[{"href":"https:\/\/blogs.rch.org.au\/grandrounds\/wp-json\/wp\/v2\/posts\/1920","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.rch.org.au\/grandrounds\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.rch.org.au\/grandrounds\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.rch.org.au\/grandrounds\/wp-json\/wp\/v2\/users\/97"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.rch.org.au\/grandrounds\/wp-json\/wp\/v2\/comments?post=1920"}],"version-history":[{"count":2,"href":"https:\/\/blogs.rch.org.au\/grandrounds\/wp-json\/wp\/v2\/posts\/1920\/revisions"}],"predecessor-version":[{"id":1922,"href":"https:\/\/blogs.rch.org.au\/grandrounds\/wp-json\/wp\/v2\/posts\/1920\/revisions\/1922"}],"wp:attachment":[{"href":"https:\/\/blogs.rch.org.au\/grandrounds\/wp-json\/wp\/v2\/media?parent=1920"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.rch.org.au\/grandrounds\/wp-json\/wp\/v2\/categories?post=1920"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.rch.org.au\/grandrounds\/wp-json\/wp\/v2\/tags?post=1920"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}