Brain Plasticity After Hand and Face Allotransplantation

Abstract

The traumatic amputation of a hand is devastating because instantly dispossesses an individual from extremely well-developed upper limb sensory functions as well as the capacity to perform precision movements. Likewise, the face can be considered as a sophisticated organ of expressivity and communication, carrying important symbolic, social, and psychological significance. Thus, severe hand or facial traumatic loss can be lifelong impairing and strongly dysfunctional. Recent advances in the domain of transplantation are endowing severely deformed and/or functionally impaired patients with the possibility of receiving composite tissue allografts (CTA). The hand and face allograft are examples of CTA transplantation that contain skin, subcutaneous tissues, muscles, vessels, and nerves. Changes in the cortical motor representations induced by traumatic hand amputation have been shown to be overturned after hand allograft. Based on principles of plasticity underlying hand amputation and allograft, we will herein discuss hypotheses and set predictions regarding cortical changes after limb and face allograft.