Farm worker has world's first double arm transplant

The procedure was carried out on a 54-year-old man who lost both limbs in a farming accident six years ago. A 30-strong German surgical team attached the donor arms last Friday in an operation which lasted more than 16 hours.

Details have only just emerged of the medical breakthrough at the Isar Clinic in Munich. The identity of the patient is being kept secret but it is understood he is making a good recovery. Doctors said he woke up and smiled at his wife. He is expected to leave hospital in five weeks.

Plastic surgeon Professor Edgar Biemer and colleague Christof Hoehnke performed the delicate operation using the arms of a 19-year-old donor.

Forearm and hand transplants have been carried out before but this is the first operation involving complete limbs.

Professor Biemer said it was only now that the technology and skill needed for such an operation were available. He said: "The forces of rejection are stronger with these organs than with any others because the skin is the largest immune barrier for the body. It instinctively rejects skin it doesn't recognise.

"New medicines have been developed to stop this rejection and the patient in this case will be taking this medicine all his life."

The patient, a farm worker who lost his arms in a threshing machine, approached Professor Biemer after seeing him on TV. Dr Biemer said that the man was "of the right stuff" psychologically.

He said: "He came to me and asked quite simply if I could perform a transplant operation for both his arms.

"One needs an extremely stable state of mind to be able to handle something as big as this but he was made of the right stuff."

The medical staff were divided into five teams to carry out the transplant.

Two teams removed one arm each from the donor and another two teams prepared the patient. A fifth team then removed veins from the donor which were vital to allow a good blood flow.

Screws and bars were used for joining.

The surgical staff were also successful in connecting up the five most important nerves in the arm with the shoulder.

It could be two years before the patient gets feeling in his fingertips.

Dr Biemer said: "He won't play the piano but otherwise he will live much better than before."