An American soldier who lost all four of his limbs has successfully undergone a rare and complicated double arm transplant. Brendan Marrocco, 26, was hit by a roadside bomb in 2009, and was the first soldier to survive quadruple limb loss from the war in Iraq.

While Mr Marrocco is not the first person to undergo a double arm transplant – he is the seventh – surgeons at Johns Hopkins hospital in Baltimore, where the operation took place, say his was “the most complicated one” so far.

For nearly four years he had waited for the transplant, before finally learning that two donor arms had become available on December 16th – less than two months after his Staten Island home, which had been specially converted to accommodate his disability, was badly flooded during Hurricane Sandy.

His transplants, which took place on December 18th, involved the connection of bones, blood vessels, muscles, tendons, nerves and skin on both arms. He also received bone marrow from the deceased donor of his arms; a therapy intended to help his body accept the new limbs with minimal medication.

While the early signs are positive – he wrote on Twitter after the surgery that his new limbs “already move a little” – doctors say it could be some time before the full functionality of his arms will be known.

His surgeon says it will take more than a year to know how fully Mr Marrocco will be able to use the new arms.
“The maximum speed is an inch a month for nerve regeneration,” Dr W P Andrew Lee, who led the 13-hour surgery at Johns Hopkins Hospital in Baltimore, Maryland, told a news conference.

It is, however, hoped that his new arms will allow him to support himself on prosthetic legs and walk unaided for the first time since he was wounded. Other patients who have undergone similar transplants have ultimately been able to tie their shoelaces and use chopsticks, doctors said.

Mr Marrocco spoke for the first time about the procedure, saying that he felt like himself again. He said, “I hated not having arms,” he said. “Not having arms takes so much away from you. You talk with your hands, you do so much with your hands. When you don’t have that, you’re kind of lost for a while. I just want to get to the point where I can be completely on my own and just get back to enjoying life,” he added.

The Nascar enthusiast was asked what he was most looking forward to doing with his new limbs.

“Driving,” he replied immediately. “Absolutely, driving. I used to love to drive. It was a lot of fun for me so I am really looking forward to getting back to that.”

He added that he wanted to “become an athlete again” telling reporters that he was a keen soccer player in his youth. He said: “Obviously I will not be playing that again. Right now I’m going to focus on hand cycling.

While Mr Marrocco’s surgery carried inevitable risks, he said that he had never wavered in his desire to go through with the operation. “I have overcome so much in the past four years and really the worst case scenario was…I go back to the way I was.”

Inevitably Mr Marrocco’s story will give hope to other war veterans who lose limbs in battle

Asked if he had a message for those in a similar position, he said: “Not to give up hope,” before adding: “I still thought of myself as being normal. I hated the word handicapped. I never really looked at it like that and now I’m just looking forward to doing everything I was doing four years ago.”