Since losing his arms in a horrific threshing accident life has been a misery for a 54-year-old German farmer. Unable to tie his laces, feed himself or touch his wife, he was close to suicide.

Then he saw a television film about an Austrian policeman who was given new hands after unpacking a parcel bomb - the farmer promptly volunteered for what may be the world’s first double whole arm transplant. Now he has the arms of a teenager and is waiting to feel his fingers again.

Doctors at Munich’s Clinic on the Right Side of the Isar said today that the farmer - his name is being withheld - was doing well after the operation last weekend.

“It was a terrific team operation,” said Dr Christoph Hoehnke, one of the lead surgeons.

In fact five teams were involved, a total of 30 doctors working for 15 hours. Two teams removed the arms from the body of the 19-year-old, a car crash victim from Augsburg in Bavaria. The youth had been declared brain dead but was kept on life support until the transplant operation had been set up. Two further teams then connected the arms to the farmer. A fifth team removed veins from the donor to allow for better blood flow in the patient.

The doctors are hailing the marathon operation as a breakthrough - “it’s a new era for medicine in Germany”, said Dr Hoehnke.

The so-called bodily extremities are much more difficult to transplant than hearts, lungs and kidneys. This is because of the large expanse of sensitive skin. “The forces of rejection are stronger with limbs than with any other transplants,” said Professor Edgar Biemer, the 65-year-old plastic surgeon who coordinated the teams.

“The skin is the largest immune barrier for the body - it instinctively rejects skin it doesn’t recognise.” As a result the patient will have to take immunity-suppressing medication for the rest of his life. Other transplant patients have found that this not only increases infections but also seems to heighten the risk of cancer.

Every day there is a risk of physical rejection of the new limbs and it is therefore difficult to assess the long-term outcome. The nerves in the new limbs grow at about 1mm per day. The farmer will not know for some two years whether feeling will return to his fingertips.

That has led some medical specialists to criticise transplant operations which are not carried out directly to save life. The German Ethics Committee however cleared the way for a double arm operation some seven years ago; it was merely a matter of waiting for the right patient.

The farmer could not apparently cope even with the most modern of prosthetic limbs that were offered to him after the accident six years ago. His supervising psychologist, Sibylle Storkebaum argued after months of consultations with the farmer that the operation would indeed be lifesaving for the despairing man. “He was really in a crisis,” she said.

“Since the accident there has been no normal life for him - he was dependent on outside help for everything.”

The operation was remarkably complex. The dead arms had to be kept filled with blood after they had been sliced off. That meant chilling them - but attaching them with chilled blood inside could have killed the patient. The doctors had to switch on the blood supply to one arm and then to the second arm half an hour later. The surgeons had to join the bone of the donor’s upper arm to the patient’s shoulder sockets before connecting the arteries and veins.

Although the operation was justified as being vital for the psychological survival of the farmer, it is psychological problems that often undo the work of the doctors. The first hand transplant, carried out in Lyon, France, 10 years ago, was seen as the beginning of a revolution for some amputees.

The Australian Clint Hallam had lost his hand in an accident with a circular saw 16 years earlier. The surgery was successful but Mr Hallam said he could never shake off the feeling that his hand belonged to somebody else. It was removed at his request three years after the operation.

The German farmer will be given not only physiotherapy but also psychological counselling in order to build an emotional relationship with his new arms. His fingerprints, of course, are now different. “This is more than a piece of surgery,” says a therapist at Munich University, “the doctors are grafting a completely new identity on this man".

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