Hand surgery in organ transplant patients

This study presents a series of organ transplant patients who developed problems that affected their upper extremities, related to the organ transplant operation itself, to the patient’s underlying systemic disease, to long-term immunosuppression, or to subsequent hand injury after the organ transplant surgery. A retrospective chart review of 40 organ transplant patients with upper extremity problems at 3 major organ transplant centers was performed. Six general problems were identified that affected the hand and upper extremity in these transplant patients: inflammatory conditions (16), nerve compression syndromes (18), infections (6), neoplasms (6), vascular problems (4), and trauma (14). Thirty-eight patients had 72 separate hand procedures. No problems were encountered with postoperative infections, and skin and bony healing occurred uneventfully. Organ transplant patients are prone to developing atypical infections, skin malignancies, ischemia, and various nerve compression syndromes that affect the hand. These patients with upper-extremity problems should be treated in a manner similar to any patient without prior organ transplant.