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On Jan. 24, 1999, doctors performed the nation’s first hand transplant at the Jewish Hospital in Louisville, Ky. (The world’s first successful hand transplant took place last September in Lyons, France.) Hospital spokeswoman Barbara Keane says the patient, Matt Scott, is adjusting well; he shows no signs of rejection and can even open and close his new hand.

Scott did not have to pay for the procedure, but Keane estimates that the operation, first year of rehabilitation, and medication will cost about $150,000. Over the next three months, Scott will attend physical therapy sessions six days a week to gain strength and a greater range of motion in his hand. He must also take a combination of drugs, including three immunosuppressants, which will cost $24,000 per year. Scott, like all other transplant recipients, will require varying doses of these drugs for the rest of his life, or as long as he has the hand.

The large number of amputee soldiers returning from World War II sparked the demand for modern American prosthetic science. Since then, biomedical engineers have developed a variety of prosthetic limbs that afford increasing comfort and mobility. Hand amputees can choose from cosmetic silicone models (starting at $1,500), which look real but offer no mobility; body-powered prostheses (about $10,000), which offer limited motion capabilities; and electrically powered prostheses (starting at $15,000), which allow a broad range of motion and a stronger grip. Attachments are available for fishing, swimming, and other activities (a “pool shooter” costs between $500 and $1,000). Obligatory biannual checkups start at $150. There are approximately 10,000 new upper-limb amputees each year, about half of whom purchase prosthetic replacements.

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