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Patient preferences of patient selection criteria for upper extremity vascularized composite allotransplantation: A qualitative study

BACKGROUND: Upper extremity vascularized composite allotransplantation is a life-enhancing reconstructive treatment option that aims to improve recipients’ quality of life and maximize function. This study assessed upper extremity vascularized composite allotransplantation patient selection criteria...

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Autores principales: Vanterpool, Karen B., Gacki-Smith, Jessica, Downey, Max C., Nordstrom, Michelle, Luken, Michelle, Riggleman, Tiffany, Fichter, Shannon, Altema, Withney, Jensen, Sally E., Dumanian, Gregory A., Cooney, Carisa M., Levan, Macey L., Tintle, Scott, Brandacher, Gerald, Gordon, Elisa J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10278401/
https://www.ncbi.nlm.nih.gov/pubmed/37342616
http://dx.doi.org/10.1177/20503121231181236
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author Vanterpool, Karen B.
Gacki-Smith, Jessica
Downey, Max C.
Nordstrom, Michelle
Luken, Michelle
Riggleman, Tiffany
Fichter, Shannon
Altema, Withney
Jensen, Sally E.
Dumanian, Gregory A.
Cooney, Carisa M.
Levan, Macey L.
Tintle, Scott
Brandacher, Gerald
Gordon, Elisa J.
author_facet Vanterpool, Karen B.
Gacki-Smith, Jessica
Downey, Max C.
Nordstrom, Michelle
Luken, Michelle
Riggleman, Tiffany
Fichter, Shannon
Altema, Withney
Jensen, Sally E.
Dumanian, Gregory A.
Cooney, Carisa M.
Levan, Macey L.
Tintle, Scott
Brandacher, Gerald
Gordon, Elisa J.
author_sort Vanterpool, Karen B.
collection PubMed
description BACKGROUND: Upper extremity vascularized composite allotransplantation is a life-enhancing reconstructive treatment option that aims to improve recipients’ quality of life and maximize function. This study assessed upper extremity vascularized composite allotransplantation patient selection criteria perceptions among individuals with upper extremity limb loss. The perceptions of individuals with upper extremity limb loss on patient selection criteria may enable vascularized composite allotransplantation centers to improve criteria to avoid mismatched expectations about the posttransplant vascularized composite allotransplantation experience and outcomes. Realistic patient expectations may increase patient adherence, improve outcomes, and reduce vascularized composite allotransplantation graft loss. METHODS: We conducted in-depth interviews with civilian and military service members with upper extremity limb loss and upper extremity vascularized composite allotransplantation candidates, participants, and recipients from three US institutions. Interviews assessed perceptions of patient selection criteria for suitability as a candidate for upper extremity vascularized composite allotransplantation. Thematic analysis was used to analyze qualitative data. RESULTS: A total of 50 individuals participated (66% participation rate). Most participants were male (78%), White (72%), with a unilateral limb loss (84%), and a mean age of 45 years. Six themes emerged regarding upper extremity vascularized composite allotransplantation patient selection criteria, including support for candidates who: (1) are of younger age, (2) are in good physical health, (3) have mental stability, (4) are willing to “put in the work,” (5) have specific amputation characteristics, and (6) have sufficient social support. Patients had preferences about selecting candidates with unilateral versus bilateral limb loss. CONCLUSIONS: Our findings suggest that numerous factors, including medical, social, and psychological characteristics, inform patients’ perceptions of patient selection criteria for upper extremity vascularized composite allotransplantation. Patient perceptions of patient selection criteria should inform the development of validated screening measures that optimize patient outcomes.
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spelling pubmed-102784012023-06-20 Patient preferences of patient selection criteria for upper extremity vascularized composite allotransplantation: A qualitative study Vanterpool, Karen B. Gacki-Smith, Jessica Downey, Max C. Nordstrom, Michelle Luken, Michelle Riggleman, Tiffany Fichter, Shannon Altema, Withney Jensen, Sally E. Dumanian, Gregory A. Cooney, Carisa M. Levan, Macey L. Tintle, Scott Brandacher, Gerald Gordon, Elisa J. SAGE Open Med Original Article BACKGROUND: Upper extremity vascularized composite allotransplantation is a life-enhancing reconstructive treatment option that aims to improve recipients’ quality of life and maximize function. This study assessed upper extremity vascularized composite allotransplantation patient selection criteria perceptions among individuals with upper extremity limb loss. The perceptions of individuals with upper extremity limb loss on patient selection criteria may enable vascularized composite allotransplantation centers to improve criteria to avoid mismatched expectations about the posttransplant vascularized composite allotransplantation experience and outcomes. Realistic patient expectations may increase patient adherence, improve outcomes, and reduce vascularized composite allotransplantation graft loss. METHODS: We conducted in-depth interviews with civilian and military service members with upper extremity limb loss and upper extremity vascularized composite allotransplantation candidates, participants, and recipients from three US institutions. Interviews assessed perceptions of patient selection criteria for suitability as a candidate for upper extremity vascularized composite allotransplantation. Thematic analysis was used to analyze qualitative data. RESULTS: A total of 50 individuals participated (66% participation rate). Most participants were male (78%), White (72%), with a unilateral limb loss (84%), and a mean age of 45 years. Six themes emerged regarding upper extremity vascularized composite allotransplantation patient selection criteria, including support for candidates who: (1) are of younger age, (2) are in good physical health, (3) have mental stability, (4) are willing to “put in the work,” (5) have specific amputation characteristics, and (6) have sufficient social support. Patients had preferences about selecting candidates with unilateral versus bilateral limb loss. CONCLUSIONS: Our findings suggest that numerous factors, including medical, social, and psychological characteristics, inform patients’ perceptions of patient selection criteria for upper extremity vascularized composite allotransplantation. Patient perceptions of patient selection criteria should inform the development of validated screening measures that optimize patient outcomes. SAGE Publications 2023-06-15 /pmc/articles/PMC10278401/ /pubmed/37342616 http://dx.doi.org/10.1177/20503121231181236 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Article
Vanterpool, Karen B.
Gacki-Smith, Jessica
Downey, Max C.
Nordstrom, Michelle
Luken, Michelle
Riggleman, Tiffany
Fichter, Shannon
Altema, Withney
Jensen, Sally E.
Dumanian, Gregory A.
Cooney, Carisa M.
Levan, Macey L.
Tintle, Scott
Brandacher, Gerald
Gordon, Elisa J.
Patient preferences of patient selection criteria for upper extremity vascularized composite allotransplantation: A qualitative study
title Patient preferences of patient selection criteria for upper extremity vascularized composite allotransplantation: A qualitative study
title_full Patient preferences of patient selection criteria for upper extremity vascularized composite allotransplantation: A qualitative study
title_fullStr Patient preferences of patient selection criteria for upper extremity vascularized composite allotransplantation: A qualitative study
title_full_unstemmed Patient preferences of patient selection criteria for upper extremity vascularized composite allotransplantation: A qualitative study
title_short Patient preferences of patient selection criteria for upper extremity vascularized composite allotransplantation: A qualitative study
title_sort patient preferences of patient selection criteria for upper extremity vascularized composite allotransplantation: a qualitative study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10278401/
https://www.ncbi.nlm.nih.gov/pubmed/37342616
http://dx.doi.org/10.1177/20503121231181236
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