World's first double arm transplant patient lauds results

Karl Merk, a dairy farmer, gave a press conference with his doctors at the teaching hospital of the Technical University in the southern German city of Munich, where he underwent the transplant managed by a 40-strong medical team.

Six years ago a work accident had led to the amputation of both his arms.

"The feeling is indescribable," Merk said as he showed off the arms, which are being supported by a special "corset" while the healing continues. "Everyday I gain more mobility."

The procedure, a world first, was conducted July 25 and 26 and doctors have been closely monitoring Merk's progress as he undergoes physical therapy as well as psychological counselling.

Five teams working in two operating rooms gathered at 10:00 pm the night of the operation, one on each side of the patient and the donor, who had died only hours before. A fifth group removed a leg vein from the donor.

The first step was to expose the muscle, nerves and blood vessels to be connected. Before the bones of the donor could be cut, blood vessels in his arms were filled with a cooled preservation solution.

Both arms were then removed exactly at the point matching the patient's arm stumps. First the bones were joined, then arteries and veins to ensure blood circulation as quickly as possible. The surgeons then attached the muscles and tendons, then the nerves and finally the skin.

The doctors said in a statement that there had been "no sign" that Merk's immune system was rejecting the foreign tissue, as was feared before the procedure, and that his scars were healing well.

The medical team said that hand and lower arm transplants were still rare and that the Munich operation, by attaching an elbow joint as well as an upper arm, posed a greater challenge for the immune and circulatory systems.