German man first to receive double arm transplant

From AFP:

BERLIN — A German whose arms were severed by a combine harvester said July 22 he expected soon to be able to raise a glass of Bavarian beer to toast the success of his world-first transplant operation.

Karl Merk (pictured) , 55, a dairy farmer from the southern German city of Munich, showed off his new dexterity in front of the cameras one year after doctors grafted new limbs onto his body in a landmark surgical procedure.

Waving his arms around and scratching his head, a delighted Merk said he had been able to fulfil a long-held dream to ride a bike again and hug his family.

Asked if he was able to drink a glass of beer in typical Bavarian fashion, Merk said: "Well, yeah, at the moment I'm drinking from a straw otherwise it would be a bit dangerous but it should happen soon."

However, he said his life was "basically back to normal" after the 15-hour surgery carried out by around 40 doctors, surgeons and nurses on July 25 and 26 last year.

"My biggest dream is to be able to move my fingers a bit and basically do everything independently for myself," Merk added.

Nevertheless, the double amputee said he was able to enjoy simple pleasures again. "It's going really well. I often go with my wife to walk the dog," he said.

And doctors revealed that he was able to ride his bike again, albeit with the help of special equipment.

Christoph Hoehnke, head of the transplant team, said: "I was bowled over when I saw Mr Merk cycling past me during my last visit."

Merk said his best moment in the past year was when he lifted up his new arms for the first time.

"At the beginning, I didn't dare to believe it," he said, in a thick Bavarian accent. "The first three or four weeks were hard, but I would do it again straightaway," he said.

"I'm feeling fit as a fiddle and am enjoying my new life," he said.

He demonstrated some of the gruelling rehabilitation exercises he must perform daily to regain strength, crossing his arms several times for the cameras.

He also showed how he was able to lift his arms above his head and lean forward on his forearms.

He said he was gradually regaining control of his movements. "Already at the start of the year I could slowly bend my arms again. Now I can move my wrist and I can now gently bend the fingers on my left hand."

The spectacular transplant, carried out at the teaching hospital of the Technical University in Munich, was a pioneering operation and the only one ever performed.

Five teams working in two operating theatres, gathered at 10:00 pm on 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 the donor's arms were then removed exactly at the point corresponding to Merk's arm stumps. First the bones were joined, then arteries and veins to ensure blood circulation as quickly as possible.

The surgeons attached the muscles and tendons, then the nerves and finally the skin.

Although Merk's body had tried to reject the transplanted arms three times, this was overcome with drugs that he will have to take for the rest of his life, doctors said.

Hoehnke said: "It is our intention today to show people, who may have a similar handicap ... what is possible in certain circumstances."

"Mr Merk is much further along than we thought he would be. Now we can confirm that the operation has been a success. Nevertheless, there is still a long way to go until he will regain full functionality in his arms," he added.

"He was a fantastic patient," Hoehnke said, beaming.