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Surgeons prepare for Australia's first double -

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ELEANOR HALL: A plumber from Cobden in Victoria's west is about to become Australia's first double
hand transplant patient.

He was a healthy and active man, until he lost both his hands because of a bacterial infection.

Now, Melbourne-based microsurgeons are preparing to perform the delicate procedure as Timothy
McDonald reports.

TIMOTHY MCDONALD: Sixty-four-year-old Peter Walsh can't pick up his young grandchildren.

PETER WALSH: You'd love to be able to pick them up and do that, but I can't. I might drop them.

TIMOTHY MCDONALD: He lost both his hands and his feet to a bacterial infection, and there are now
many day-to-day tasks that are just too difficult.

But all that could be about to change, Mr Walsh is set to become Australia's first hand transplant
patient. Once a donor is found, he'll undergo surgery by a team of specialists from the
Melbourne-based O'Brien Institute.

The director Professor Wayne Morrison says it's a very complicated procedure.

WAYNE MORRISON: You would identify the bones and then arteries and veins. Arteries bring in the
circulation and the veins drain the circulation. We'd join the nerves together to give feeling back
into the skin and we would join the tendons, which will make the fingers flex and extend to give
you grip.

TIMOTHY MCDONALD: And how much function could he realistically hope to regain?

WAYNE MORRISON: Well fairly quickly you would expect he would gain that crude function of grip. In
other words the tendons will be joined to the tendons in the hand. Now the tendons in the patient
are motorised by his own muscles, which are still intact of course, so they're already functioning.

So, it's really just joining tendons together, and once the tendons heal after three to four weeks,
he will go into intensive physiotherapy.

TIMOTHY MCDONALD: It's then that the harder task of regaining the more complicated pinching
function will begin. What's more, he'll be forced to take some very harsh drugs to ensure that his
body doesn't reject his new hands.

Mr Walsh says he understands the risks, and he's optimistic about his prospects.

PETER WALSH: That was me only worry but then I've talked to people about it and they've had
medication and that for over 20 years and it's getting a lot better.

TIMOTHY MCDONALD: The drugs are the same ones that are prescribed to liver or kidney transplant

The difference is recipients of a liver or kidney transplant won't survive without their new organ,
so there's very little to lose by taking anti-rejection drugs.

The same can't be said for a hand transplant.

Professor Morrison says the drugs are likely to shorten Mr Walsh's life, but his quality of life
will improve dramatically.

WAYNE MORRISON: Renal transplants regularly now gain 15 or 20 years. This man is already 64,
another 20 years for him, I think he sees that as a quality of life thing. For the next 20 years
he'd rather be able to, as he graphically describes himself, be able to wipe his tail and feed
himself and not be a total burden to his family for the sake of perhaps a loss of two or three

TIMOTHY MCDONALD: Professor Morrison says he has misgivings about hand transplants more generally,
because many people would have their lives shortened significantly for the sake of a slightly
better life.

He says this is especially true for patients who already have one hand.

WAYNE MORRISON: You're really not increasing their quality of life that much given that
transplanted hands are never going to be quite normal hands.

TIMOTHY MCDONALD: But he says Mr Walsh's case is exceptional, because he understands the risks, and
the fact that he's currently missing both hands and feet means the trade-off between life
expectancy and quality of life is worth it.

ELEANOR HALL: Timothy McDonald reporting.