Human hand transplantation, in the modern era of immunosuppression, began in 1998 when the first case was performed in Lyon, France. Since that time multiple hand transplants have been performed around the world. The peak incidence was in 2000 with seven hand transplants, four being unilateral and three bilateral (Fig. 14.1). Through 2003, 18 hand transplants had been confirmed. Following an approximately 3-year hiatus with no reported hand transplants, two additional transplants were performed in 2006. Two patients, whose hand allografts had been removed because of rejection, underwent the original operations in 1998 and 1999.