{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T02:37:07Z","timestamp":1783996627138,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,11,27]],"date-time":"2018-11-27T00:00:00Z","timestamp":1543276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004694","name":"Kaohsiung Medical University","doi-asserted-by":"publisher","award":["KMUOR06"],"award-info":[{"award-number":["KMUOR06"]}],"id":[{"id":"10.13039\/501100004694","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011645","name":"Kaohsiung Medical University Chung-Ho Memorial Hospital","doi-asserted-by":"publisher","award":["SA10601"],"award-info":[{"award-number":["SA10601"]}],"id":[{"id":"10.13039\/501100011645","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Vascularized composite allotransplantation represents as an emerging field in reconstructive surgery. However, some complications can be associated with the procedure. The authors describe a case of bone infarctions of the bilateral hip joints following the first hand allotransplantation in Taiwan. A 45\u2010year\u2010old man who experienced a traumatic amputation of the distal third of his forearm received a hand transplantation from a brain\u2010dead donor. Immunosuppression included antithymocyte globulins, and bolus methylprednisolone (Solu\u2010Medrol) was used for the induction. The maintenance therapy protocol included systemic tacrolimus, mycophenolate mofetil, and prednisone. The patient discontinued the systemic steroid 15\u2009months after surgery. Two episodes of acute rejections were observed at 105 and 810\u2009days after surgery. These signs disappeared after pulse therapy with Solu\u2010Medrol, titration with tacrolimus, and topical immunosuppressive creams (tacrolimus and clobetasol). However, the patient felt pain in both hips after long periods of standing 30\u2009months after the transplantation. A pelvic radiograph and magnetic resonance imaging revealed avascular necrosis (AVN) in both hip joints. Because of the progressive worsening of the pain, the patient underwent a decompression surgery on the left hip involving a fibula bone graft. The patient underwent a right hip hemi\u2010arthroplasty with a bipolar prosthesis 3\u2009months later. The patient remained in good health without major complications. These findings indicate that systemic steroids and tacrolimus might be the major predisposing factors for the induction of AVN after hand allotransplantation.<\/jats:p>","DOI":"10.1002\/micr.30375","type":"journal-article","created":{"date-parts":[[2018,11,27]],"date-time":"2018-11-27T19:12:35Z","timestamp":1543345955000},"page":"349-353","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Bone infarction of the hip after hand allotransplantation: A case report"],"prefix":"10.1002","volume":"39","author":[{"given":"Yur\u2010Ren","family":"Kuo","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery Kaohsiung Medical University Hospital  Kaohsiung Taiwan"},{"name":"Faculty of Medicine, College of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"Department of Biological Sciences National Sun Yat\u2010Sen University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien\u2010Chang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Plastic &amp; Reconstructive Surgery Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun\u2010Wen","family":"Wang","sequence":"additional","affiliation":[{"name":"Orthopedics, Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jui\u2010Kun","family":"Chang","sequence":"additional","affiliation":[{"name":"Rehabilitation, Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Chi","family":"Huang","sequence":"additional","affiliation":[{"name":"Rehabilitation, Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng\u2010Chung","family":"Pan","sequence":"additional","affiliation":[{"name":"Pharmacology, Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Chun","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Plastic &amp; 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