It has taken months of gruelling rehabilitation and daily doses of strong drugs, but Australia's only hand transplant recipient is doing well after two years.
"I have full feeling," says Peter Walsh, 67, a plumber from regional Victoria.
"They did a great job. It's excellent," says the world's oldest hand transplant recipient.
His life is a far cry from the dependency he was facing in 2006, when doctors amputated both hands and both legs after a bacterial infection.
He has artificial legs and surgeons have fashioned a semi-functional left thumb. He received the new right hand in 2011 and several months later managed to write a thank you letter to the family of his donor.
"My wife, Margaret, does not have to put me to bed anymore. I'm quite independent now. Give me time and I can do most things," says Mr Walsh, who is one of 51 hand recipients in modern medicine and the only one to have the operation in the southern hemisphere.
It is early in the process, but Mr Walsh's doctors are pleased, according to a case study in the latest issue of the Medical Journal of Australia.
Not mentioning Mr Walsh by name, they say he has made impressive functional gains in dressing, eating, writing and attending to personal hygiene.
According to the journal, the transplant team led by Dr Karen Dwyer and Professor Wayne Morrison at St Vincent's Hospital, Melbourne, stirred controversy because of Mr Walsh's age.
But in an interview with AAP, Dr Dwyer says physical and psychological health are the major factors.
"He was pretty healthy with a good heart and good lungs.
"Hand transplants are risky, but I think Peter would agree any complications that may arise are probably worth the improved quality of life."
Dr Dwyer says the patient's psychological state is a major factor.
"This is something that is very visible to you and the outside world. It is different from a heart or a kidney."
She says Mr Walsh's commitment to his medication and rehabilitation are major factors in the success so far.
"People have lost their hand because they did not take to their medication."
She says the surgery is very intricate, but the main issue is the suitability of patient.
"It is not something that is put on and works the next day."
