The launch of the upper extremity transplantation program: clinical cases and key aspects of organizing work in a new area of clinical transplantology

The loss of an arm (or both arms), not only causes severe physical trauma but also leads to long-term psychological consequences and difficulties in occupational, domestic, and social maladjustment, substantially impairing quality of life. This complex problem is not always addressed effectively with modern high-tech bionic prostheses, which, while enabling the performance of many functional tasks, have inherent limitations. In selected cases, allograft transplantation of an upper limb from a deceased donor may be considered. Until recently, this treatment option was unavailable within the Russian healthcare system. This paper presents the key stages in establishing an upper limb transplant program, including its organizational structure, the roles of its individual components, and the outcomes of practical implementation. The efficacy and safety of the treatment method are illustrated through the first two clinical cases. The experience gained and the outcomes of the first clinical cases are intended to demonstrate the practical feasibility of developing a structured, effective upper limb transplant program that can address the growing demand for this type of high-tech medical care.