Perspectives of US and Australian hand therapists about pediatric hand transplantation

INTRODUCTION 

Pediatric hand transplantation (PHT), an investigational therapy, was recently performed in the United States.

RESEARCH QUESTIONS

Perspectives of hand therapists about PHT patient selection (inclusion and exclusion criteria), team configuration, patient assent, and patient compliance were explored.

DESIGN

Quantitative survey. We used a research ethics committee-approved 18-question e-link anonymous questionnaire to survey members of the American Society of Hand Therapists and the Australian (AU) Hand Therapy Association for their perspectives on PHT.

RESULTS

All surveyed hand therapists work with children (n = 18 Australia [AU], n = 85 United States) and some had been involved in adult hand transplant rehabilitation (28% AU, 21% United States; P = .543, not significant (NS)). The US and AU therapists differ regarding their opinions on multidisciplinary team membership, smoking as an exclusion criterion, and risk of posttransplant rehabilitation noncompliance.

DISCUSSION

This research opens a dialogue on the clinical and ethical complexity of PHT, including team configuration, inclusion/exclusion criteria, the assent process, and rehabilitation access/compliance. Furthermore, international perspectives are informative as they highlight funding and access issues and can potentially guide global professional society policy.