World's first double arm transplant as man gets teenager's limbs in 16-hour operation

By Allan Hall
Last updated at 12:13 PM on 02nd August 2008

Doctors have released pictures of the first man to have a double arm transplant.
The German man who was not named for legal reasons made medical history by having two complete arms transplanted.

He has been given the arms of a teenage boy who is believed to have died in a car crash. The 54-year-old patient lost both of his arms in a farming accident six years ago.

The operation, which was conducted at the Klinikum rechts der Isar hospital in Munich by a team of 30 experts lead by Edgar Biemer and Christoph Hoehnke, lasted over 16 hours from Friday until Saturday last week.

The German man has been given the arms of a teenage boy who is believed to have died in a car crash

The arm donor who had been declared brain dead was kept alive on a life support until the arms were ready to be transplanted.

The hospital said that the dead arms had to be kept filled with blood when severed and chilled to keep them alive, but that attaching them with chilled blood inside would have killed the 54-year-old man.

They avoided the problem by switching on the blood supply to one arm and then to the second arm half an hour later.

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Two teams of transplant experts at a clinic in Munich attached two donor arms to the 54-year-old male patient

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The man who was not named for legal reasons made medical history

The patient, who lost his arms in a threshing machine six years ago, is said to be recovering well from the surgery. Doctors said he regained consciousness on Sunday and smiled at his wife.

He is expected to remain in hospital for five weeks of intensive therapy.

Professor Edgar Biemer who performed the operation. The patient approached him with the idea after seeing him on TV

Doctors warned it was too early to say whether the transplant would succeed.

Professor Biemer, 65, said: ‘The forces of rejection are stronger with limbs than with any other transplants 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.’

He said it was difficult to forecast the psychological effect on the man of having the arms of a youth 35 years his junior.

The donor was a 19-year-old boy from Augsburg in Bavaria. He has not been named.

One therapist at the Isar Clinic, where the patient is recovering, said: ‘At 54, he will have to come to terms with the fact that limbs he has been without for so long are back, but that they are those of a much younger person.

The world's first hand transplant recipient, Clint Hallam, from New Zealand, poses for photographs after his surgery in 1999

‘We shall have to tell him to take it easy on the weightlifting. Getting younger arms might make him feel the years have slipped away but it won’t have much effect on his physical strength.’

The medical staff were divided into five teams for the marathon operation. Two teams each removed one arm from the donor, while two others prepared the patient to receive them.

The fifth team removed veins from the donor which had to be taken as part of the transplant to allow for a better blood flow.

Professor Biemer said the surgeons then joined the bone of the donor’s upper arm to the patient’s shoulder sockets before connecting arteries and veins.

Although the nerve casings were successfully transplanted as well, new nerves have to grow. It could be two years before the patient gets feeling in his fingertips.

The first limb transplant, carried out in Lyon, France, in September 1998, gave Australian Clint Hallam a new hand. He had lost his 16 years earlier in an accident with a circular saw.

Although the surgery was successful, Mr Hallam later said he had become ‘mentally detached’ from the hand and it was removed at his request in February 2001.

French surgeons gave Isabelle Dinoire, 38, a partial face transplant two and a half years ago after she was savaged by a dog.

And five years ago an Austrian patient had a partial arm transplant, in which new hands and lower arms were attached.

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