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Functional RecoveryNCT07810790

Upper Extremity Vascularized Composite Allotransplantation: A Study Evaluating Safety, Functional Outcomes, and Patient-Reported Psychosocial Outcomes

A study testing Upper Extremity Vascularized Composite Allotransplantation (VCA) in people with Functional Recovery and Upper Extremity Vascularized Composite Allotransplantation, run by Yale University at 9 sites in United States.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

The primary objective of this study is to evaluate the 5-year (60-month) allograft survival rate of upper extremity vascularized composite allotransplantation performed under the standardized CONSORT clinical protocol. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Upper Extremity Vascularized Composite Allotransplantation (VCA)
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
5 participants
Where
9 sitesUnited States
Study dates
Oct 2027to Oct 2037
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Participants:
  • Competent to provide informed consent, as determined through structured clinical assessment by qualified study personnel, and able to demonstrate adequate psychosocial support, including caregiver or other support-person assistance as needed, to facilitate postoperative recovery, adherence to immunosuppressive therapy, and long-term study follow-up.
  • where feasible, to support psychosocial and aesthetic integration.
  • Willingness to undergo comprehensive psychosocial evaluation and ongoing monitoring by the multidisciplinary team.
  • Demonstrated motivation for transplantation and understanding of the investigational nature of upper extremity VCA, including its risks, potential benefits, alternatives, and long-term commitments.
  • Evidence of psychological stability and adaptive coping, with attention to prior trauma, grief, and body-image disturbances; stable treatment for conditions such as depression, anxiety, or post-traumatic stress disorder is acceptable when documented and appropriately managed.
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  • Demonstrated capacity for adherence and, when available, a history of adherence to complex medical regimens, such as chronic disease treatment, dialysis, or transplant care, recognizing that prior barriers may be mitigated through structured supports and longitudinal follow-up.
  • Availability of adequate family, caregiver, and/or social support, including an identified caregiver, support person, or formal support services, sufficient to assist with postoperative recovery, medication adherence, transportation, and psychosocial needs. A caregiver/family information sheet will be provided to support persons to promote realistic expectations prior to consent.
  • Final psychosocial approval by a transplant mental health professional in consultation with the broader psychosocial team.
  • Severe upper extremity disfigurement involving amputation proximal to the wrist.
  • Conventional restorative options, including advanced myoelectric or body-powered prostheses, must be documented as exhausted (defined as a minimum of 12 months of consistent use of myoelectric or body-powered prostheses with a QuickDASH score remaining above 30), infeasible (due to stump length or soft tissue coverage), or clinically inadequate for restoring the sensory-motor integration required for the participant's essential functional needs.
  • Identified plan for access to immunosuppressive medications and required follow up care (e.g., insurance coverage, assistance programs, institutional support), coordinated with social work and financial counseling.
  • Willingness and ability, with available supports, to attend required follow up visits (in person or via approved telehealth where appropriate).
  • Donor:
  • Legal declaration of brain death
  • Documented consent for VCA donation.
  • ABO and HLA compatibility with the intended recipient.
  • Negative crossmatch with the intended recipient (unless protocol specified exceptions are approved by immunology and the IRB).
  • EBV and CMV serostatus known (CMV mismatch (donor-positive/recipient-negative (D+/R-) is not automatically exclusionary but managed by the multidisciplinary study team).
  • Upper extremity anatomy suitable for transplant (no significant upper extremity trauma, major congenital anomalies, or prior upper extremity surgery that would preclude safe procurement or acceptable aesthetic/functional outcomes).
  • Reasonably matched skin tone and sex, where feasible, to support psychosocial and aesthetic integration.

Who cannot join

  • Anatomical or surgical factors that render transplantation unsafe or technically unfeasible (e.g., prohibitive vascular disease, prior surgeries precluding adequate anastomoses) in the judgment of the surgical team.
  • Positive Human Immunodeficiency Virus (HIV) serology (unless future evidence and institutional policy support inclusion under tightly controlled conditions).
  • Active or inadequately treated serious infection, including tuberculosis, hepatitis B or C with uncontrolled viremia, or syphilis.
  • Active malignancy.
  • History of melanoma or other high risk, virus driven malignancies.
  • Malignancy in remission <5 years, except for selected low risk, non viral cancers explicitly reviewed and approved by the transplant team.
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  • Must have clearance for transplant from oncology.
  • Decompensated liver disease without hepatology clearance
  • Decompensated or advanced cirrhosis
  • Uncontrolled or uncorrectable comorbidities that substantially elevate perioperative or immunosuppressive risk despite optimization efforts (e.g., uncontrolled diabetes with end organ damage, uncontrolled hypertension, uncorrected coagulopathy).
  • Current pregnancy or stated intent to become pregnant within 12 months of transplant.
  • Inability or unwillingness to use effective contraception, when applicable.
  • Documented pattern of poor adherence or inability to engage with follow up despite reasonable, trauma informed efforts to reduce barriers (e.g., transportation, scheduling, health literacy, financial support).
  • Active psychiatric illness that currently impairs judgment, decisional capacity, or capacity to adhere to care (e.g., untreated psychosis, severe untreated depression with suicidality, impaired reality testing), as determined by the transplant psychosocial team.
  • Smoking at the time of transplantation (including cigarettes, vaping, or nicotine products)
  • Active substance use disorder (alcohol or drugs) without sustained remission and without adequate recovery supports, unless the multidisciplinary team determines that risk has been sufficiently mitigated.
  • Persistent, unrealistic expectations about transplant outcomes that do not resolve despite structured education and counseling.
  • Absence of any viable psychosocial or financial support pathway after reasonable efforts to develop one (e.g., no caregiver and no alternative formal support options, or no feasible mechanism to obtain essential medications).
  • Inability to provide informed consent, even with appropriate accommodations (e.g., language services, plain language materials, decision aids), and no appropriate legally authorized representative where required.
  • Any other condition or circumstance judged by the multidisciplinary transplant team and IRB to pose unacceptable risk or compromise ethical conduct of the study.
  • Donor:
  • Positive serology for HIV, HBV, HCV, TB, or syphilis, or other identified transmissible infections per current OPTN/UNOS and PHS guidance. HTLV testing will be conducted in line with current OPTN standards for donors with potential transmissible infections that are treatable in the recipient.
  • Known history of cancer, especially head/neck or hematologic malignancy.
  • Permanent upper extremity tattoos or highly identifiable markings judged incompatible with the recipient's preferences or the clinical/ethical judgment of the transplant team.
  • History of extremity radiation that compromises tissue viability.
  • Public Health Service (PHS) increased risk donors (e.g., recent IV drug use, incarceration) will not be automatically excluded but will require case by case risk assessment, full disclosure to the recipient, and documented multidisciplinary approval.

Trial locations and contacts

9 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Omowunmi Afolabi, MSc. Psychology contact

203-737-4752

omowunmi.afolabi@yale.edu

9 sites in 1 country

United States9 sites
  • Johns Hopkins Medicine

    Baltimore, Maryland, 21205

  • Brigham and Women's Hospital

    Boston, Massachusetts, 02115

  • Cleveland Clinic

    Cleveland, Ohio, 44195

  • Cedars-Sinai Medical Center

    Los Angeles, California, 90048

  • University of Louisville

    Louisville, Kentucky, 40292

  • Yale New Haven Hospital / Yale University

    New Haven, Connecticut, 06519

  • NYU Langone Health

    New York, New York, 10016

  • University of Pennsylvania

    Philadelphia, Pennsylvania, 19104

  • Mayo Clinic

    Rochester, Minnesota, 55902

Other trials in United States

About this study

Official title: Upper Extremity Vascularized Composite Allotransplantation: A Prospective Interventional Study Evaluating Safety, Functional Outcomes, and Patient-Reported Psychosocial Outcomes

The primary objective of this study is to evaluate the 5-year (60-month) allograft survival rate of upper extremity vascularized composite allotransplantation performed under the standardized CONSORT clinical protocol.

Read the detailed description

The study population includes adults with severe upper extremity disfigurement meeting the following criteria:

  • Anatomic Severity: Loss of upper extremity proximal to the wrist (including transhumeral and shoulder-level levels when clinically appropriate)
  • Refractory Status: prosthesis delivered unsatisfactory results
Being tested
Upper Extremity Vascularized Composite Allotransplantation (VCA)
Keywords
Composite tissue allotransplantation, Rehabilitation, Vascularized composite allotransplantation, Upper-extremity transplantation, Hand transplantation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Upper Extremity Vascularized Composite Allotransplantation (VCA)Procedure or surgery

    Upper Extremity VCA, performed to treat severe facial defects. This procedure will be performed by qualified surgeons in accordance with standard institutional surgical practices.

Study groups in NCT07810790
Study groupRoleWhat they receive
Upper Extremity Composite AllotransplantationExperimentalUpper Extremity VCA performed under a standardized CONSORT clinical protocol. The study utilizes a longitudinal cohort design where each participant serves as their own control pre and post transplant.
Receives: Procedure: Upper Extremity Vascularized Composite Allotransplantation (VCA)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of participants with Allograft Survival at 60 months

    Allograft survival is defined as the continued presence of the transplanted upper extremity tissue with evidence of adequate vascular perfusion assessed as clinical evaluation by the surgical team. Survival is a binary categorical variable (Success/Failure). Failure is defined as total graft loss necessitating surgical removal (explantation).

    Measured: Day 0 (surgery), weekly during initial hospitalization, months 1, 3, 6, 12, 18, 24, and annually thereafter through Month 60

Secondary outcomes (20)
  1. Mean Active Range of Motion

    Measured in degrees for the transplanted joint (the elbow (in some occasions), the wrist, metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints).

    Measured: Baseline, 3, 6, 12, 24, 36, 48 and 60 months

  2. Muscle strength assessed using Clinical Motor Grading (MRC Scale)

    Medical Research Council (MRC) Scale is a standardized 0-to-5 manual muscle testing system used by clinicians to grade muscle strength and motor power. Motor strength was graded on a scale from M0 to M5, where M0 indicates no visible muscle contraction and M5 indicates normal muscle strength against full resistance

    Measured: Baseline, 3, 6, 12, 24, 36, 48 and 60 months

  3. Mean Grip Strength

    Quantified in kilograms (kg) using a calibrated hand dynamometer

    Measured: Baseline, 3, 6, 12, 24, 36, 48 and 60 months

  4. Mean Pinch Strength

    Quantified in kilograms (kg) using a calibrated pinch gauge

    Measured: Baseline, 3, 6, 12, 24, 36, 48 and 60 months

  5. Carroll Upper Extremity Function Test (UEFT)

    A validated composite score of 33 tasks used to measure overall functional capability. Uses a 0 to 3 scale for individual task performance:0 points: Cannot complete any portion.1 point: Completes part of the test item.2 points: Completes the item slowly or clumsily.3 points: Completes the item fully and normally.Yields a cumulative score up to 99 for the dominant hand and 96 for the non-dominant hand

    Measured: Baseline, 3, 6, 12, 24, 36, 48 and 60 months

  6. 9-Hole Peg Test (9-HPT)

    Measured in seconds to quantify manual dexterity and fine motor coordination.

    Measured: Baseline, 3, 6, 12, 24, 36, 48 and 60 months

  7. Sensory Detection Thresholds assessed using Semmes-Weinstein monofilament test

    Evaluates light touch thresholds and protective sensation loss in hands, feet, or limbs. Determined by the minimum size of Semmes-Weinstein monofilament perceived by the patient.

    Measured: Baseline, 3, 6, 12, 24, 36, 48 and 60 months

  8. Tactile Acuity (2PD)

    Measured by Static Two-Point Discrimination in millimeters (mm).

    Measured: Baseline, 3, 6, 12, 24, 36, 48 and 60 months

  9. Mean score General Health Status (PROMIS-29 v2.0)

    29-item questionnaire that measures general physical, mental, and social health-related quality of life. Results are converted into T-scores where 50 is the average for the U.S. general population, with a standard deviation of 10. Higher score means worse symptoms or better ability.

    Measured: Baseline, 3, 6, 12, 24, 36, 48 and 60 months

  10. Mean score Health Utility (EQ-5D-5L)

    EQ-5D-5L is a standardized participant completed questionnaire that measures health-related quality of life. It consists of consists of 5 dimensions each scored: 1= no problems, 2= slight problems, 3=moderate problems, 4= severe problems, and 5= extreme problems. Higher scores indicated greater levels of problems across each of the five dimensions.

    Measured: Baseline, 3, 6, 12, 24, 36, 48 and 60 months

  11. Mean score LIMB-QOL Resilience, Self Care and Fine Motor

    Evaluates resilience, self care and fine motor following major extremity injury. Higher scores reflect a more positive outcome. Scored on a T-score metric with a mean of 50 and a standard deviation of 10.

    Measured: Baseline, 3, 6, 12, 24, 36, 48 and 60 months

  12. Mean score Upper Extremity Disability (QuickDASH)

    An 11-item self-reported tool measuring upper extremity physical function and symptoms. Scores range from 0 (no disability) to 100 (most severe disability).

    Measured: Baseline, 3, 6, 12, 24, 36, 48 and 60 months

  13. Number of participants with Opportunistic infections

    Number of participants with Opportunistic infections

    Measured: Day 0 (surgery) through Month 60

  14. Number of participants with Malignancies

    Number of participants with Malignancies

    Measured: Day 0 (surgery) through Month 60

  15. Number of participants with Organ toxicity

    Number of participants with Organ toxicity

    Measured: Day 0 (surgery) through Month 60

  16. Number of participants that complete all assessments

    Number of participants that complete all assessments

    Measured: Day 0 (surgery) through Month 60

  17. Number of participants that complete the Central Review Agreement

    Number of participants that complete the Central Review Agreement

    Measured: Day 0 (surgery) through Month 60

  18. Acute Rejection Incidence and Severity

    The total number of Biopsy-Proven Acute Rejection (BPAR) episodes per patient and their severity as graded by the Banff VCA classification.

    Measured: Weekly for the first month, monthly for the first year, quarterly until end of study (month 60)

  19. Mean days to Reversibility of Acute Rejection

    Measured by the Time to Clinical Resolution, defined as the number of days from the initiation of anti-rejection therapy to the return of the allograft to baseline clinical appearance and/or a follow-up biopsy showing a lower Banff grade or resolution.

    Measured: Weekly for the first month, monthly for the first year, quarterly until end of study (month 60)

  20. Number of participants with Chronic Allograft Rejection (CLAD/CAV):

    Number of participants with Chronic Allograft Vasculopathy (CAV) or chronic skin changes as identified via protocol-driven histopathology.

    Measured: Weekly for the first month, monthly for the first year, quarterly until end of study (month 60)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Sep 2026
  2. Study startOct 2027 (estimated)
  3. Primary completionOct 2037 (estimated)
  4. Study completionOct 2037 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
A total of five procedures will be performed. Given the five-procedure cap, enrollment opportunities will be limited and dependent upon donor availability, candidate eligibility, multidisciplinary review, and regulatory readiness across participating sites.
Masking
None (open label)
Enrolment
5 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07810790
Sponsor's protocol ID
2000042327
Other IDs
HT9425-23-3-0001
Status last verified
Sep 2026
First submitted
3 Sep 2026
Last updated
15 Sep 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Upper Extremity Vascularized Composite Allotransplantation (VCA) in people with Functional Recovery and Upper Extremity Vascularized Composite Allotransplantation, run by Yale University at 9 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 21 inclusion and 26 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 15 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Omowunmi Afolabi, MSc. Psychology (203-737-4752, omowunmi.afolabi@yale.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of participants with Allograft Survival at 60 months (time frame: Day 0 (surgery), weekly during initial hospitalization, months 1, 3, 6, 12, 18, 24, and annually thereafter through Month 60). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Sep 2026.

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