Miribel

This research focuses on adults aged 18 to 60 who have experienced the rare and serious condition of double amputation of both forearms. It evaluates and compares two treatment strategies: bilateral allograft (transplant) of the hands and forearms versus the use of prosthetic forehands. The aim is to assess these options in terms of costs, quality of life, usefulness, satisfaction, autonomy, and social integration, building on previous findings that hand transplants can restore autonomy but require immunosuppressive treatment. Participants may receive either a bilateral allograft of the hands and forearms or prosthetic forehands. The transplant group must meet specific health criteria, such as having had their amputation at least three months prior and no severe psychiatric or uncontrolled medical conditions. The study compares the two approaches, considering both medical and economic outcomes over time. During the study, researchers will monitor costs and other important outcomes over 36 months. They will assess autonomy, quality of life, and social integration, along with medical complications related to treatments. The study builds on earlier results showing that hand transplants can help patients regain function and return to work, despite the need for ongoing immunosuppression and possible risks. This evaluation will help guide treatment choices for patients with bilateral upper limb amputations.