Identifying Health-Related Quality of Life Domains After Upper Extremity Transplantation

Objective To identify the most important health-related quality of life (HRQOL) domains and patient-reported outcomes after upper extremity transplantation (UET) in individuals with upper extremity amputation. Design Verbatim audio-recordings of individual interviews and focus groups were analyzed using qualitative, grounded theory-based methods to identify important domains of HRQOL and provide guidance for outcomes measurement after UET. Setting Individual interviews were conducted by phone. Focus groups were conducted at 5 upper extremity vascularized composite allotransplantation (VCA) centers in the US and at an international conference of VCA experts. Participants Individual phone interviews were conducted with 5 individuals with lived experience of UET. Thirteen focus groups were conducted with a total of 59 clinical professionals involved in UET. Interventions Not applicable. Main Outcome Measures Not applicable. Results Twenty-eight key HRQOL domains were identified, including physical functioning and medical complications, positive and negative emotional functioning, and social participation, relations, and independence. We identified key constructs for use in evaluation of the potentially substantial physical, medical, social, and emotional effects of UET. Conclusions This study provides an overview of the most important issues affecting HRQOL after UET, including several topics that are unique to individuals with UET. This information will be used to establish systematic, comprehensive, and longitudinal measurement of post-UET HRQOL outcomes.
This article was originally published in Archives of Physical Medicine and Rehabilitation. © 2023 by the American Congress of Rehabilitation Medicine. Published by Elsevier Inc. The version of record is available at:
hand transplant, patient-reported outcomes, quality of life, reconstructive, transplantation, rehabilitation, upper extremity, upper-limb amputation, vascularized, composite allotransplantation
Tulsky, David S., Pamela A. Kisala, Callie E. Tyner, Jerry Slotkin, Christina Kaufman, Christopher L. Dearth, Annamarie D. Horan, et al. “Identifying Health-Related Quality of Life Domains After Upper Extremity Transplantation.” Archives of Physical Medicine and Rehabilitation 104, no. 6 (June 1, 2023): 878–91.