The First Successful Lower Extremity Transplantation: 6-Year Follow-Up and Implications for Cortical Plasticity
The First Successful Lower Extremity Transplantation: 6-Year Follow-Up and Implications for Cortical Plasticity
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DOI：
10.1111/j.1600-6143.2011.03782.x
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发表时间：
2011-12-01
影响因子：
8.8
通讯作者：
Zuker, R. M.
中科院分区：
文献类型：
--
作者：
Fattah, A.;Cypel, T.;Zuker, R. M.
带血管的同种异体复合移植作为一种可行的重建选择正在得到认可，新病例的报告频率也在增加，包括手、面部和喉部移植。然而，到目前为止，只有一例成功的完全下肢移植，其中一例坐骨神经双胞胎的功能肢体被移植到另一例，其中一例伴有致命的心脏异常。六年后，患者行动能力良好，并在一所主流学校与同龄人一起参加体育活动。运动和感觉功能的临床评估显示良好的功能效果。生活质量评估采用简明健康状况调查表和揭示高水平社会和身体能力的下肢功能量表。功能磁共振成像显示肢体皮质整合；皮质可塑性和带血管的同种异体复合移植在矫正先天性肢体畸形方面的意义被提出。
Vascularized composite allotransplantation as a viable reconstructive option is gaining recognition and new cases are being reported with increasing frequency including hand, face and laryngeal transplantation. However, only one successful complete lower limb transplantation has been reported to date, in which a functioning limb from one ischiopagus twin with a lethal cardiac anomaly was transplanted to the other. Six years later, the patient is mobilizing well and engaging in sporting activities with her peers in a mainstream school. Clinical evaluation of motor and sensory modalities demonstrated a good functional result. Quality of life was assessed using the short form-36 health survey and lower extremity functional scale disclosing a high level of social and physical capacity. Functional magnetic resonance imaging was performed and showed cortical integration of the limb; the implications of cortical plasticity and vascularized composite allotransplantation for the correction of congenital limb anomalies are presented.