ArticlePlastic and reconstructive surgery2010
An economic analysis of hand transplantation in the United States.
Article in Plastic and reconstructive surgery, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Cost-utility studies in upper limb orthopaedic surgery: a systematic review of published literature.The bone & joint journal · 2018Pooled it
- Composite Tissue Transplant of Hand or Arm: A Health Technology Assessment.Ontario health technology assessment series · 2016Pooled it
- Cost-effectiveness of the long-term use of temozolomide for treating newly diagnosed glioblastoma in Germany.Journal of neuro-oncology · 2018Trial
- Immunosuppressive and antiinfectious regimens in vascular composite allograft recipients-a systematic review.Frontiers in transplantation · 2025Review
- Crowdsourcing Opinions and Awareness of Upper Extremity Transplantation in the United States.Cureus · 2024Article
- The Future of Microsurgery: Vascularized Composite Allotransplantation and Engineering Vascularized Tissue.Journal of hand and microsurgery · 2024Article
- Methods of ex vivo analysis of tissue status in vascularized composite allografts.Journal of translational medicine · 2023Review
- Special Considerations for Secondary Surgery After Upper Extremity Transplantation.Hand (New York, N.Y.) · 2022Article
- Review
- Bionic Prostheses: The Emerging Alternative to Vascularised Composite Allotransplantation of the Limb.Frontiers in surgery · 2022Review
- Education for patients with limb loss or absence: Aging, overuse concerns, and patient treatment knowledge gaps.Frontiers in psychology · 2022Article
- Hand Transplants, Daily Functioning, and the Human Capacity for Limb Regeneration.Frontiers in cell and developmental biology · 2022Article
- A Systematic Review of Health State Utility Values in the Plastic Surgery Literature.Plastic and reconstructive surgery. Global open · 2021Article
- Pediatric Hand Transplantation: A Decision Analysis.Hand (New York, N.Y.) · 2021Article
- All hands on deck: Hand replantation versus transplantation.SAGE open medicine · 2020Article
- Bionic reconstruction : Restoration of extremity function with osseointegrated and mind-controlled prostheses.Wiener klinische Wochenschrift · 2019Article
- Using Decision Analysis to Understand the Indications for Unilateral Hand Transplantation.Hand (New York, N.Y.) · 2016Article
- Discussion: A Methodology for Determining Standard of Care Status for a New Surgical Procedure: Hand Transplantation.Plastic and reconstructive surgery · 2016Article
- Article
- Regenerative Engineering and Bionic Limbs.Rare metals · 2015Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundHand transplantation has received international attention in recent years; however, the economic impact of this innovative treatment is uncertain. The aim of this study was to assess the utility and estimate the costs of hand transplantation and the use of hand prostheses for forearm amputations.
methodsOne hundred medical students completed a time trade-off survey to assess the utilities of single and double hand transplantation and the use of hand prostheses. Quality-adjusted life years (QALYs) were calculated for each outcome to create decision trees. Cost data for medical care were estimated based on Medicare fee schedules using the Current Procedural Terminology code for forearm replantation. The cost of immunosuppressive therapy was estimated based on the wholesale price of drugs. The incremental cost-utility ratio was calculated from the differences in costs and utilities between transplantation and prosthesis. Sensitivity analyses were performed to assess the robustness of the results.
resultsFor unilateral hand amputation, prosthetic use was favored over hand transplantation (30.00 QALYs versus 28.81 QALYs; p = 0.03). Double hand transplantation was favored over the use of prostheses (26.73 QALYs versus 25.20 QALYs; p = 0.01). The incremental cost-utility ratio of double transplantation when compared with prostheses was $381,961/QALY, exceeding the traditionally accepted cost-effectiveness threshold of $50,000/QALY.
conclusionsProsthetic adaption is the dominant strategy for unilateral hand amputation. For bilateral hand amputation, double hand transplantation exceeds the societally acceptable threshold for general adoption. Improvements in immunosuppressive strategies may change the incremental cost-utility ratio for hand transplantation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.