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- Article] Investigation of risk acceptance in hand transplantation
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DocNo of ILP: 4937
Doc. Type: Article
Title: Investigation of risk acceptance in hand transplantation
Authors: Majzoub, RK; Cunningham, M; Grossi, F; Maldonado, C; Banis, JC; Barker, JH
Full Name of Authors: Majzoub, RK; Cunningham, M; Grossi, F; Maldonado, C; Banis, JC; Barker, JH
Keywords by Author: composite tissue allotransplantation; hand transplant; immunosuppression; risk versus benefit; risk acceptance; standard gamble; time trade-off
Keywords Plus: COMPOSITE-TISSUE-TRANSPLANTATION; MYCOPHENOLATE-MOFETIL; HEALTH STATES; TACROLIMUS; CANCER; CYCLOSPORINE; MULTICENTER; RECIPIENTS; TRIAL
Abstract: Purpose: Twenty-four hands have been transplanted in 18 individuals and clinicians continue to debate whether the risks justify the benefits in these procedures. To assess quantitatively the risks versus benefits in hand transplantation we used a validated instrument (Louisville Instrument for Transplantation) to measure the degree of risk individuals are willing to accept to receive different types of transplantation procedures. Methods: The Louisville Instrument for Transplantation contains 237 standardized questions that incorporate modified standard gamble and time trade-off outcome measures and questions that assess body image perception, depression, self-esteem, optimism, socially desirable responding, and demographics. Respondents were questioned on the extent to which they would trade off specific numbers of life-years or sustain other costs in exchange for receiving 7 different transplantation procedures. For this study we questioned 227 individuals in 4 study populations with differing life experiences: healthy individuals, organ transplant recipients, upper-extremity amputee patients, and lower-extremity amputee patients. Results: All populations questioned perceived risk similarly despite their differing life experiences and would accept differing degrees of risk for the different transplantation procedures. Organ transplant recipients were the most risk-tolerant group whereas upper-extremity amputee patients were the most risk adverse, even when considering a single hand transplant. All groups that were questioned would accept a higher degree of risk to receive a double versus a single hand transplant. Conclusions: By questioning individuals who have experienced directly the risks of immunosuppression and those who could benefit from hand transplantation, this study presents an empiric basis for assessing risk versus benefit in this procedure.
Cate of OECD: Clinical medicine
Year of Publication: 2006
Business Area: other
Detail Business: medicine & science
Country: USA
Study Area:
Name of Journal: JOURNAL OF HAND SURGERY-AMERICAN VOLUME
Language: English
Country of Authors: Univ Louisville, Dept Surg, Louisville, KY 40202 USA; Univ Louisville, Dept Commun & Psychol, Louisville, KY 40202 USA
Press Adress: Barker, JH (reprint author), Univ Louisville, Dept Surg, 320 MDR Bldg,511 S Floyd St, Louisville, KY 40202 USA.
Email Address: jhbark01@louisville.edu
Citaion:
Funding:
Lists of Citation: Cooney WP, 2002, J HAND SURG-AM, V27A, P165, DOI 10.1053/jhsu.2002.30367; CUNNINGHAM M, 2004, EUR J TRAUMA, V30, P12, DOI 10.1007/s00068-004-1369-x; Daoud AJ, 1998, TRANSPLANT P, V30, P4079, DOI 10.1016/S0041-1345(98)01348-7; de Mattos AM, 2000, AM J KIDNEY DIS, V35, P333, DOI 10.1016/S0272-6386(00)70348-9; Dubernard JM, 1999, LANCET, V353, P1315, DOI 10.1016/S0140-6736(99)02062-0; Edgell SE, 2001, J HAND SURG-AM, V26A, P196, DOI 10.1053/jhsu.2001.20152; Foucher G, 1999, LANCET, V353, P1286, DOI 10.1016/S0140-6736(99)00112-9; Francois CG, 2000, MICROSURG, V20, P360, DOI 10.1002/1098-2752(2000)20:8<360::AID-MICR4>3.0.CO;2-E; GILL TM, 1994, JAMA-J AM MED ASSOC, V272, P619, DOI 10.1001/jama.272.8.619; Gorantla V, 2001, EUR J TRAUMA, V27, P267; Hausman MR, 2003, MT SINAI J MED, V70, P148; Herndon JH, 2000, NEW ENGL J MED, V343, P503, DOI 10.1056/NEJM200008173430710; Hettiaratchy S, 2001, LANCET, V357, P494, DOI 10.1016/S0140-6736(00)04037-X; Hovius SER, 2001, J HAND SURG-BRIT EUR, V26, P519, DOI 10.1054/jhsb.2001.0673; Jalukar V, 1998, HEAD NECK-J SCI SPEC, V20, P600, DOI 10.1002/(SICI)1097-0347(199810)20:7<600::AID-HED4>3.0.CO;2-1; Johnson C, 2000, TRANSPLANTATION, V69, P834; Jones JW, 2000, NEW ENGL J MED, V343, P468, DOI 10.1056/NEJM200008173430704; Jones NF, 2002, J HAND SURG-AM, V27A, P771, DOI 10.1053/jhsu.2002.34373; Kahneman D., 2000, CHOICES VALUES FRAME; Klapheke MM, 1999, B MENNINGER CLIN, V63, P159; Krabbe PFM, 1996, MED DECIS MAKING, V16, P120, DOI 10.1177/0272989X9601600204; Lee WPA, 2001, PLAST RECONSTR SURG, V107, P1066; Lloyd A, 2001, MED DECIS MAKING, V21, P141; Lubbe AS, 2003, TRANSPLANTATION, V75, P1916, DOI 10.1097/01.TP.0000065290.60470.9E; McCabe S, 1998, TRANSPLANT P, V30, P2783, DOI 10.1016/S0041-1345(98)00808-2; Miller J, 1999, TRANSPLANT P, V31, P276, DOI 10.1016/S0041-1345(98)01625-X; Scott LJ, 2003, DRUGS, V63, P1247, DOI 10.2165/00003495-200363120-00006; SLEVIN ML, 1990, BRIT MED J, V300, P1458; SOX H, 1998, MED DECIS MAKING, P150; Stratta RJ, 1997, TRANSPLANT P, V29, P654, DOI 10.1016/S0041-1345(96)00383-1; Uzzo RG, 2004, BJU INT, V93, P955, DOI 10.1111/j.1464-410X.2004.04759.x
Number of Citaion: 31
Publication: W B SAUNDERS CO-ELSEVIER INC
City of Publication: PHILADELPHIA
Address of Publication: INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA
ISSN: 0363-5023
29-Character Source Abbreviation: J HAND SURG-AM
ISO Source Abbreviation: J. Hand Surg.-Am. Vol.
Volume: 31A
Version: 2
Start of File: 295
End of File: 302
DOI: 10.1016/j.jhsa.2005.09.013
Number of Pages: 8
Web of Science Category: Orthopedics; Surgery
Subject Category: Orthopedics; Surgery
Document Delivery Number: 015NU
Unique Article Identifier: WOS:000235558900020
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