{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:16:53Z","timestamp":1777940213139,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"vor","delay-in-days":366,"URL":"http:\/\/www.sagepub.com\/licence-information-for-chorus"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["K12HS026379"],"award-info":[{"award-number":["K12HS026379"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000005","name":"Department of Defense","doi-asserted-by":"crossref","award":["W81XWH-18-1-0676"],"award-info":[{"award-number":["W81XWH-18-1-0676"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Prog Transpl"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Advancements in vascularized composite allotransplantation have made hand transplants possible for persons living with upper limb loss. Hand transplantation is not a life-saving procedure, but rather a quality-of-life enhancing procedure; hence the risk of morbidity and mortality must be weighed against improvements in function and appearance. This study explored the decision-making process of patients evaluated for hand transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods\/Approach<\/jats:title>\n                    <jats:p>A qualitative case series study using retrospective chart data of evaluations was conducted between January 1, 2011 and February 28, 2020. Notes were extracted and read by three reviewers. Each case was summarized noting similarities and differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Nine patients underwent evaluation. Eight were no longer under evaluation and did not receive transplant; one was still undergoing evaluation. Patient motivations for evaluation were dissatisfaction with prostheses or self-image, chronic pain, performing activities of daily living, occupation, burden placed on caregivers, and concerns about overuse of non-affected limbs. Patients chose not to pursue transplantation due to rehabilitation time, immunosuppression, alternative treatments, and social and financial challenges. The clinical team discontinued evaluations due to unmet evaluation requirements, medical contraindications, or treatment alternatives. Different modes of shared decision-making were present depending on the party most heavily featured in the charts as driving decisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This was an examination of shared decision-making with hand transplant candidates who did not proceed to transplant. Reasons for choosing alternative strategies for management were multifactorial. Lessons learned regarding patient motivations and shared decision-making can inform future interventions to better support patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15269248231189863","type":"journal-article","created":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T02:30:39Z","timestamp":1691029839000},"page":"216-222","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["A Single-Center Retrospective Evaluation of Decision-Making and Factors Motivating Hand Transplant Candidates"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5637-6803","authenticated-orcid":false,"given":"Kasey R.","family":"Boehmer","sequence":"first","affiliation":[{"name":"Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA"},{"name":"Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassie C.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA"},{"name":"Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA"},{"name":"The William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian G.","family":"Hargraves","sequence":"additional","affiliation":[{"name":"Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan M.","family":"Griffin","sequence":"additional","affiliation":[{"name":"Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA"},{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea E.","family":"Garcia-Bautista","sequence":"additional","affiliation":[{"name":"Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2631-6591","authenticated-orcid":false,"given":"Brianna B.","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avudaiappan","family":"Chokkalingam","sequence":"additional","affiliation":[{"name":"The William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawn M.","family":"Finnie","sequence":"additional","affiliation":[{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam R.","family":"Miller","sequence":"additional","affiliation":[{"name":"The William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven L.","family":"Moran","sequence":"additional","affiliation":[{"name":"The William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA"},{"name":"Department of Surgery, Division of Plastic Surgery, Mayo Clinic, Rochester, MN, USA"},{"name":"The Essam and Dalal Obaid Center for Reconstructive Transplantation, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fantley C.","family":"Smither","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hatem","family":"Amer","sequence":"additional","affiliation":[{"name":"The William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA"},{"name":"The Essam and Dalal Obaid Center for Reconstructive Transplantation, Mayo Clinic, Rochester, MN, USA"},{"name":"Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila","family":"Jowsey-Gregoire","sequence":"additional","affiliation":[{"name":"The William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN, USA"},{"name":"The Essam and Dalal Obaid Center for Reconstructive Transplantation, Mayo Clinic, Rochester, MN, USA"},{"name":"Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,8,2]]},"reference":[{"key":"bibr1-15269248231189863","unstructured":"John Hopkins Medicine. Human Upper Extremity Allotransplantation. Accessed April 5, 2023. https:\/\/www.hopkinsmedicine.org\/transplant\/programs\/reconstructive-transplant\/hand-arm-transplant.html."},{"key":"bibr2-15269248231189863","doi-asserted-by":"publisher","DOI":"10.1007\/s11019-018-09881-4"},{"key":"bibr3-15269248231189863","doi-asserted-by":"publisher","DOI":"10.2147\/PROM.S44694"},{"key":"bibr4-15269248231189863","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-020-02546-x"},{"key":"bibr5-15269248231189863","doi-asserted-by":"publisher","DOI":"10.1186\/s41687-019-0095-4"},{"key":"bibr6-15269248231189863","doi-asserted-by":"publisher","DOI":"10.2147\/PROM.S191480"},{"key":"bibr7-15269248231189863","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2012.06.010"},{"key":"bibr8-15269248231189863","unstructured":"Sifferlin A. \u2018I Can Do Absolutely Nothing.\u2019 The First American With a Double Hand Transplant Wants Them Removed. Time July 25, 2016. 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