The History and Evolution of Hand Transplantation, World Experience After More Than a Decade of Clinical Hand Transplantation, How to Establish a Hand Transplant Program, Recipient Selection ? Who is the Right Candidate for Hand Transplantation? Donor-related Issues in Hand Transplantation, Surgical and Technical Aspects of Hand Transplantation ? Is it Just Another Replant? Functional Outcome After Hand Transplantation ? What can be Achieved? Strategies to Enhance Nerve Regeneration, Immunosuppressive Protocols and Immunological Challenges Related to Hand Transplantation, Acute and Chronic Rejection in Hand Transplantation ? What have we Learned? Favoring the Risk Benefit Balance for Hand Transplantation ? The Pittsburgh Approach Ethical, Financial and Policy Considerations of Hand Transplantation