Reporter: Charles Wooley
Producer: Stephen Taylor, Kirsty Thomson
Last year, we brought you the story of Victorian grand-dad Peter Walsh - Australia's first hand transplant recipient. For Australian medicine, it was a giant leap into the extraordinary world of limb transplant surgery. And for the sports-mad plumber with a brand new hand, it's been life changing. Indeed, the progress he has managed in just over 12 months needs to be seen to be believed.
In Australia, organ and tissue donation is managed by the national DonateLife Network, under the leadership of the Australian government’s Organ and Tissue Authority. The DonateLife Network comprises 161 clinical specialists of organ and tissue donation in 77 hospitals across Australia and 82 organ and tissue donation DonateLife agency staff in each state and territory.
DonateLife agencies facilitate the organ and tissue donation process, support donor families, provide performance data and educate clinical staff and the community on organ and tissue donation. To find out the facts about organ and tissue donation or for more information contact your nearest DonateLife agency or visit www.donatelife.gov.au
It started out as a tragedy, but ended in triumph. Just over four years ago, Victorian plumber Peter Walsh was struck down with the dreaded pneumococcal bug.
The bacteria attacked his body with such savagery doctors had to amputate his hands and feet just to keep him alive.
In an instant, Peter became completely reliant on his friends and family.
That is, until an extraordinary micro-surgeon decided to give him a helping hand, literally.
Now, Peter Walsh has made history as Australia's first hand transplant recipient.
CHARLES WOOLEY: It’s just over a month ago a crowded operating theatre at Melbourne’s St Vincent’s Hospital and an extraordinary and wonderful surgery is underway.
PROFESSOR WAYNE MORRISON: It looks very favourable; I think we’re very happy with the match.
CHARLES WOOLEY: Professor Wayne Morrison and his team are giving 65-year-old Peter Walsh the gift of a new hand and hopefully a new start in life.
PROFESSOR WAYNE MORRISON: Now these veins are going to join to the vein up here further up in the hand.
CHARLES WOOLEY: The intense concentration of the whole team is reflected in the surgeons’ eyes.
PROFESSOR WAYNE MORRISON: That looks good so we’ll continue stitching that tendon up.
CHARLES WOOLEY: But unseen behind the masks, there’s also plenty of smiles. Everyone here knows they’re making history.
PROFESSOR WAYNE MORRISON: Well we’re finished (laughter). I hope we haven’t forgotten anything inside. (chuckles)
CHARLES WOOLEY: G’day Plumber.
PETER WALSH: G’day Charlie, how are you?
CHARLES WOOLEY: Hello, how are you? Before he was a patient, Peter Walsh was a plumber and the nickname “Plumber” has stuck, even though from now on he’ll be remembered for something quite different. It looks like it belongs?
MARGARET WALSH: It does.
PETER WALSH: Yeah it does, it’s a hand.
CHARLES WOOLEY: What does it feel like?
PETER WALSH: I know it’s there.
CHARLES WOOLEY: I’ve put sanitizer on my hand, can I touch it?
PETER WALSH: Yeah, you can touch it.
CHARLES WOOLEY: Despite the heroic surgery, it feels – and looks – just like any other hand, and a week on from the operation, Plumber – and his wife Margaret – are coping well.
CHARLES WOOLEY: You wake up, what do you think?
PETER WALSH: Yeah good, it’s all finished, I’m still alive, nothing’s went wrong. And I’ve got a hand! That’s what I come for, I’ve got it.
CHARLES WOOLEY: Do we know anything about where the hand came from?
PETER WALSH: No, no.
CHARLES WOOLEY: Do you want to?
PETER WALSH: That wouldn’t worry me.
CHARLES WOOLEY: There’ll be a family somewhere watching your progress very carefully.
PETER WALSH: Yeah, they will be. They’ve had a sad time, while I’m going to have a good time, aren’t I?
CHARLES WOOLEY: You’re going to have a very good time.
PETER WALSH: Yeah. Yeah.
CHARLES WOOLEY: To know just why Plumber Walsh deserves better times, we need to go back to the difficult and dark times he’s lived through for the last four and a half years.
PETER WALSH: There’s Warnie on the front page anyhow.
CHARLES WOOLEY: Without hands and feet, everything has been a battle for him, and for Margaret.
PETER WALSH: All started when I was milking cows, Sunday morning. I thought I had a virus. I - about 6:30 I spewed. Haven’t spewed for 40 bloody years.
CHARLES WOOLEY: This country bloke from Cobden in western Victoria is not one for undue fuss. So when he became ill, Margaret knew it was serious and took him straight to hospital.
MARGARET WALSH: He was on life support in intensive care and um didn’t know whether he was going to pull through.
CHARLES WOOLEY: The infection turned out to be the frightening pneumococcal disease, which was causing potentially fatal blood poisoning. ‘Cause up til now you’ve just been worried about him surviving?
MARGARET WALSH: Yes, yeah. So they had to put him in an induced coma and the heart was you know, trying to beat the infection.
CHARLES WOOLEY: He survived a week in a coma, then awoke to see his hands and feet literally dying in front of him.
PETER WALSH: I knew I was in trouble, 2 or 3 days with the hands because I couldn’t move them, couldn’t move me fingers. They were dead. And then just gradually, gradually went black.
CHARLES WOOLEY: You’re not bad on all terrain?
PETER WALSH: No, not too bad.
CHARLES WOOLEY: Sort of 4WD aren’t you?
PETER WALSH: (Chuckle).
CHARLES WOOLEY: So is this one of yours?
PETER WALSH: Yes, yeah, yeah.
CHARLES WOOLEY: Windmills were Plumber’s specialty … Plumbing these contraptions out in the Victorian bush was where this uncomplicated bloke was at his happiest.
PETER WALSH: I can handle the feet alright, it’s the hands you know. You just feel useless.
CHARLES WOOLEY: You hate that you’re not able to help don’t you?
PETER WALSH: Yeah. That’s the part I miss is going out to the farmers and do their work and have a good talk, have a beer.
CHARLES WOOLEY: Feeling useful is a simple pleasure that no-one should be denied …
PETER WALSH: Gidday, Tommy. Have a look at this young man here, this is Tommy.
CHARLES WOOLEY: And while those closest to Plumber – his kids and grandkids – just wanted him to live, that was never going to be enough.
PETER WALSH: Do you want to know what I want to do if I get a hand Patrick, and get it working?
PETER WALSH: I wanna toss the coin at the grand final.
JANELLE: Like, it was just amazing that he lived and at the time we were saying doesn’t matter that he won’t have you know the hands. Doesn’t matter. Like we were sort of like, but then the reality set in and I said … He just loves to work. He lives to work. That was his life.
LEIGH: You could see him when he first got home he, he’d be sitting in his wheelchair and he’d just look at his hands and get upset. He’d be feeling he was just useless.
CHARLES WOOLEY: Yeah cause he’s obviously a practical, capable sort of bloke?
WAYNE: It would have been alright if he’d just lost a leg or a foot but losing two feet and two hands, it just takes everything away really, doesn’t it? Yeah.
CHARLES WOOLEY: Plumber Walsh’s luck finally changed when Melbourne micro surgeon, Professor Wayne Morrison heard about his case. What makes Peter Walsh, to your mind, the plumber as he’s known to his mates, a good candidate? Well
PROFESSOR WAYNE MORRISON: I think Plumber is a good candidate firstly because of his personality. He clearly has a personality that’s rather dominant and ah has a bit of a mind of his own.
CHARLES WOOLEY: The biggest risk with these operations comes from the potent drugs necessary to stop rejection. The side effects can be awful.
PROFESSOR WAYNE MORRISON: They include diabetes, cardiac disease, cancer, and ultimately the, the, it can be lethal.
CHARLES WOOLEY: So the operation can be successful and it can improve your life but the drugs might kill you?
PROFESSOR WAYNE MORRISON: Exactly, now …
CHARLES WOOLEY: So the life improvement needs to be considerable?
PROFESSOR WAYNE MORRISON: It does and particularly here because this is ah what we would call a non vital organ. Traditionally transplantation is for organs where if you don’t have them, you die.
CHARLES WOOLEY: With the help of specialists like anti-rejection doctor Karen Dwyer, Wayne Morrison finally decided the benefits did outweigh the risk, and in January this year, four years after Plumber’s hands were amputated, he was officially on the Transplant List. Meanwhile, Plumber tried to get on with his normal life. He and his team once again won the local bowling competition but his thoughts were a little more distant. It’s a bittersweet feeling hoping for redemption but knowing that someone has to die for your dream to come true.
PETER WALSH: That’s the worst part of it.
CHARLES WOOLEY: Lending a hand as it were, except it’s going to be a permanent gift?
PETER WALSH: Yeah, yeah. Some yeah, that’s the worst part of it, but that, that’s life isn’t it?
CHARLES WOOLEY: Well it is, yeah.
PETER WALSH: Yeah.
CHARLES WOOLEY: You haven’t been eyeing off my right hand have you?
PETER WALSH: Oh just.
CHARLES WOOLEY: It’d be a reasonable fit.
PETER WALSH: It’d work. Yeah, just, bloody be a good bowler. You bloody got long fingers. (chuckle)
CHARLES WOOLEY: I know everyone says to you, what do you want to do when you get a new hand?
PETER WALSH: Pick me nose and scratch me arse.
CHARLES WOOLEY: Pick your nose and scratch your arse?
PETER WALSH: Yeah, and …
CHARLES WOOLEY: These are two of the most natural things in the world.
PETER WALSH: Everyone does it.
CHARLES WOOLEY: Plumber’s wait was a relatively brief two months then came the excited call that a donor had been found and the easiest decision of all for Plumber to put his life in the surgeon’s hands.
PROFESSOR WAYNE MORRISON: And that’s going to join up with the median nerve on that side.
CHARLES WOOLEY: It’s complex but at the same time straightforward. In the simplest terms, the donor hand will be joined to Plumber’s right arm, just below the wrist. The bones will be connected first then the blood supply. After that, there are tendons, muscles, nerves and skin which require the finest skills of the micro-surgeons.
PROFESSOR WAYNE MORRISON: I think this wrist is a bit thicker than his so we might need a bit more skin available.
CHARLES WOOLEY: At first, two teams go to work identifying the structures on Plumber’s arm and the donor hand and then quite quickly, and without fuss, they come together.
PROFESSOR WAYNE MORRISON: Immediately now we’re going to join the bones so we get stability of the skeleton and after that we’re going to join the artery to get the blood back in the hand because there’s a critical time beyond which this part will die.
CHARLES WOOLEY: At the three hour mark, Professor Morrison is able to display a major development.
PROFESSOR WAYNE MORRISON: You see that’s going pink here? And when we press we can see a circulation, a capillary, what we call a capillary return, a flush or a blush.
CHARLES WOOLEY: In other words, with Plumber’s blood flowing through it, the donor hand is now his hand. And at this stage of the pioneering operation, it’s a great relief for everyone.
PROFESSOR WAYNE MORRISON: Yeah, that’s exactly what we’re hoping and anticipating for. In terms of viability and life, the anxiety’s over for the moment.
CHARLES WOOLEY: And while everyone’s priority is Plumber’s well-being, the donor isn’t forgotten.
DR KAREN DWYER: I’m always amazed and touched by donor families that in their time of sorrow which is often very unexpected that, that they can draw on those resources and you know be so generous in giving, giving donor organs to change somebody else’s life.
CHARLES WOOLEY: While Plumber’s operation is the first hand transplant in Australia, around the world surgeons have been doing them for over a decade. In fact, we were at the world’s first hand transplant in France in 1998.
SURGEON: The patient has had his bones joined. He has a new hand, he has a good blood flow in from two good arteries.
CHARLES WOOLEY: The recipient was New Zealander Clint Hallam but he refused to take the anti-rejection drugs and in 2001, his new hand died on his arm and was removed. But if you get the right patient, the results can be spectacular. Austrian policeman Theo Kelz had a double hand transplant in 2000. And when Tara Brown met him two years later, there was little he couldn’t do.
THEO KELZ: In the beginning, after the transplantation it’s oh, very, very difficult to write.
TARA BROWN: And now?
THEO KELZ: No, it’s not so problem.
PROFESSOR WAYNE MORRISON: It’s a very nice match um firstly it’s a right hand (chuckle) and that’s the right one, but it looks very natural.
CHARLES WOOLEY: We’re now at the business end of Plumber’s operation.
PROFESSOR WAYNE MORRISON: We’ve done all the arteries and the veins, nerves and tendons.
CHARLES WOOLEY: After nine hours, the final touches.
PROFESSOR WAYNE MORRISON: You can see the fella’s had a sun tan by the look of it compared to the other chap.
CHARLES WOOLEY: It’s remarkable to see Plumber’s new hand. Professor Morrison and his team are understandably tired but rightly happy. It’s no surprise Plumber Walsh wakes up a new man.
SHANE WARNE: Where’s the Plumber?
CHARLES WOOLEY: And as news of his surgery spreads he even gets a surprise hospital visit.
PETER WALSH: Shane Warne.
SHANE WARNE: W: Margaret, hello, Shane.
CHARLES WOOLEY: Plumber’s long admired what Shane Warne can do with his right hand.
PETER WALSH: You didn’t take long to sum up Gatting (Chuckle).
SHANE WARNE: That was a fluke mate. It was a fluke.
CHARLES WOOLEY: And you get the impression Warnie is equally impressed with Plumber’s.
SHANE WARNE: Payne could actually open the batting too.
PETER WALSH Open the bat, and keep.
SAHEN WARNE: Maybe you should be a selector?
PETER WALSH: Yeah, I know.
SHANE WARNE: Maybe you could put your hand up and be a selector. You’re all good now so you can be a selector. (chuckles)
CHARLES WOOLEY: A few days ago, I caught up with Plumber once again.
DOCTOR: We can visualise.
PETER WALSH: We can probably put a pot in it.
CHARLES WOOLEY: I think you could.
PETER WALSH: (Chuckle) With a handle.
CHARLES WOOLEY: It’s been more than a month since he and his new hand have been united and it seems they’re getting along just fine. There is the big question, in your own words, have you been able to pick your nose or scratch your bum yet?
PETER WALSH: I can pick me nose.
CHARLES WOOLEY: I know you’ve had a rough trot, but aren’t you a lucky man?
PETER WALSH: Yeah. Yeah, a good gift. Good gift you know lucky, some people are unlucky. Some families are unlucky but he left a gift didn’t he? I was, ah, I was the one to get it, yeah.
To donate life, discuss it today. OK?
St Vincent’s Hospital
St Vincent’s Hospital Melbourne is a leading public hospital providing acute medical and surgical services, emergency and critical care, aged care, diagnostics, rehabilitation, allied health, mental health, palliative care and residential care, as well as undertaking research and educating the next generation of healthcare professionals. For more information visit: www.svhm.org.au
The O'Brien Institute
The O'Brien Institute at St Vincent’s Hospital has led the way in clinical and experimental research over the past 30 years. The Institute has made striking advances in the delicate craft of replantation surgery and the transfer by microsurgical techniques of body parts and tissue to reconstruct people maimed by trauma, cancer, burns and congenital deformity.
In addition to pioneering techniques in reconstructive microsurgery, the Institute carries out internationally recognised scientific research in the fields of Tissue Engineering and Vascular Biology.
The Institute has also carried out studies on wound healing, nerve regeneration, inflammation, pain, the effects of trauma on tissue, and more recently, prostate cancer. www.bobim.org
Victorian Spleen Registry
Peter Walsh lost his limbs after an episode of infection many years after losing his spleen in an accident. People without spleens are at an increased risk of bacterial infections.
The Victorian Spleen Registry would like to inform people who do not have a spleen to make sure they are up to date with antibiotic and vaccinations treatments, to help protect them from similar infections. We would encourage them to discuss this with their doctor or they can also go to the Victorian Spleen Registry website or call (03) 9078 3828.