{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:45:17Z","timestamp":1787240717126,"version":"build-2736575974"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The impact of patient-specific psychosocial factors on functional outcomes after upper-extremity (UE) vascularized composite allotransplantation (VCA) is poorly understood. The objective of this study was to identify relevant psychosocial predictors for success or failure of UE VCA in an Austrian cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative study was undertaken consisting of semi-structured interviews with UE VCA staff, transplanted patients, and close relatives. Participants were asked about their perceptions of factors that either favored or hindered a successful transplant outcome, including functional status before surgery, preparation for transplant, decision-making, rehabilitation and functional outcome after surgery, and family and social support. Interviews were conducted online and recorded with the consent of interviewees.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four bilateral UE VCA patients, 7 healthcare professionals, and a sister of a patient participated in the study. Thematic analysis revealed the importance of an expert interdisciplinary team with adequate resources for patient selection. Psychosocial aspects of prospective candidates are crucial to evaluate as they contribute to success. Both patients and providers may be impacted by public perceptions of UE VCA. Functional outcomes are optimized with a life-long commitment to rehabilitation as well as close, ongoing provider involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Psychosocial factors are important elements in the assessment and follow-up care for UE VCA. To best capture psychosocial elements of care, protocols must be individualized, patient-centered, and interdisciplinary. Investigating psychosocial predictors and collecting outcomes is, thus, critical to justifying UE VCA as a medical intervention and to providing accurate and salient information to prospective candidates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2023.1092725","type":"journal-article","created":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T06:32:00Z","timestamp":1675924320000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Psychosocial predictors in upper-extremity vascularized composite allotransplantation: A qualitative study of multidimensional experiences including patients, healthcare professionals, and close relatives"],"prefix":"10.3389","volume":"14","author":[{"given":"Nikolas R.","family":"Hummel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin J.","family":"Zuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Talbot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe E.","family":"Zimmerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey N.","family":"Katz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Kinsley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Kumnig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1080\/15265160490496804","article-title":"A face is not just like a hand: pace Barker","volume":"4","author":"Baylis","year":"2004","journal-title":"Am. 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Am."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1002\/micr.20227","article-title":"Risk acceptance in composite-tissue allotransplantation reconstructive procedures","volume":"26","author":"Brouha","year":"2006","journal-title":"Microsurgery"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1111\/j.1600-6143.2007.01751.x","article-title":"Guidelines for the psychosocial evaluation of living unrelated kidney donors in the United States","volume":"7","author":"Dew","year":"2007","journal-title":"Am. J. Transplant."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1136\/pgmj.75.887.513","article-title":"Ethical issues in limb transplants","volume":"75","author":"Dickenson","year":"1999","journal-title":"Postgrad. Med. J."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1497","DOI":"10.1097\/TP.0b013e3181a440ae","article-title":"Pretransplant predictors of posttransplant adherence and clinical outcome: an evidence base for pretransplant psychosocial screening","volume":"87","author":"Dobbels","year":"2009","journal-title":"Transplantation"},{"key":"ref9","first-page":"13","article-title":"Hand and face allografts: myth, dream, and reality","volume":"155","author":"Dubernard","year":"2011","journal-title":"Proc. Am. Philos. Soc."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1097\/SAP.0b013e31818d45e9","article-title":"Requirements for the development of a hand transplantation program","volume":"63","author":"Gordon","year":"2009","journal-title":"Ann. Plast. 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Immunol."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1210","DOI":"10.1097\/01.tp.0000157118.28394.fa","article-title":"The international registry on hand and composite tissue transplantation","volume":"79","author":"Lanzetta","year":"2005","journal-title":"Transplantation"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1176\/appi.psy.44.6.452","article-title":"Guidelines for conducting a psychiatric evaluation of the unrelated kidney donor. Psychosomatics: journal of consultation liaison","volume":"44","author":"Leo","year":"2003","journal-title":"Psychiatry"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1037\/0090-5550.41.1.53","article-title":"Ethical issues in psychological evaluation of patients for organ transplant surgery","volume":"41","author":"Olbrisch","year":"1996","journal-title":"Rehabil. 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Surg."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1002\/1098-2752(2000)20:8<458::AID-MICR19>3.0.CO;2-G","article-title":"Ethical considerations in composite tissue allotransplantation","volume":"20","author":"Simmons","year":"2000","journal-title":"Microsurgery"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"e533","DOI":"10.1097\/GOX.0000000000000520","article-title":"Psychosocial out-comes after bilateral hand transplantation","volume":"3","author":"Singh","year":"2015","journal-title":"Plast. Reconstr. Surg."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1097\/PRS.0000000000001872","article-title":"Functional outcomes after bilateral hand transplantation: a 3.5-year comprehensive follow-up","volume":"137","author":"Singh","year":"2016","journal-title":"Plast. Reconstr. 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