Attitudes regarding lower extremity allotransplantation among lower extremity amputees

Abstract

Background: Lower limb allotransplantation is garnering increasing attention in the vascularized composite allotransplantation community as a potential treatment modality for those suffering from lower limb amputations. Little is known, however, about the level of interest among lower limb amputees regarding this procedure.

Methods: An online survey regarding lower limb allotransplantation was designed in conjunction with and distributed by the Amputee Coalition to lower limb amputees in the United States. Responses from the survey were blinded, tabulated, and analyzed for significance using chi-square or Fisher's exact test.

Results: A total of 770 respondents completed the online survey. Forty-three percent of respondents stated they would be interested in being evaluated for lower limb transplantation, 36 percent declined, and 21 percent were uncertain. Those respondents who expressed an interest in allotransplantation tended to be significantly younger, better educated, more recently amputated, and less satisfied with prosthetic outcomes than those who were not interested. The most important criterion for transplantation to be considered a success by respondents was restoration of meaningful knee/ankle joint function, followed by restoration of limb sensibility. If immunosuppression were not required, 32 percent of those who initially declined and 88 percent of those who were uncertain would choose to undergo evaluation for lower limb allotransplantation.

Conclusion: A significant proportion of lower limb amputees would be interested in undergoing evaluation for lower limb allotransplantation.