To understand just one reason why Jeff Kepner wanted to become the nation's first double hand transplant recipient this week at UPMC, consider his morning shower routine.
For much of the past decade, Mr. Kepner, who lost both hands and both feet to a bacterial infection 10 years ago, has had to put on special prosthetic "water legs" to get into the shower, and then wait for his wife Valarie to get in with him to brace him and scrub him.
"So in that sense he's totally been on my schedule," Mrs. Kepner said in an interview yesterday. "When I got up in the morning, he had to get up, too, and I don't want him to have to be on my schedule.
"More than that, I want him to be able to hold our daughter's hand and hold his grandchildren's hands some day, and I know that sounds silly, but to be able to touch again is important -- when you're missing both of your hands you're not able to do that."
Mr. Kepner, a 57-year-old retired Air Force educational planner from Augusta, Ga., received his hands here in a nine-hour surgery Monday from a 23-year-old Pennsylvania man whose family also donated his heart, liver, lungs, pancreas, kidneys and tissue to other patients.
In all, the donor, who had a 15-month-old son and was the youngest of four brothers, gave organs to five patients and tissue to 30 to 50 others, said Holly Bulvony, a spokeswoman for the Center for Organ Recovery and Education.
Mrs. Kepner said yesterday that she and Mr. Kepner have boundless gratitude toward the donor's family.
"I know it's the most difficult time in a family's life," she said, "and our thank-you's would never be enough for them. You can't put a price on donating an organ that's going to save somebody's life or donating hands that will change somebody's whole life and independence."
Mr. Kepner became the first person in the United States to receive a double hand transplant and was the second person to get a hand transplant at UPMC's new program in the past three months.
The first hand transplant recipient, former Marine Joshua Maloney of Bethel Park, was at the hospital yesterday for therapy at the same time Mrs. Kepner was being interviewed.
Dr. W.P. Andrew Lee, the chief transplant surgeon for both men, said Mr. Maloney, who lost his right hand in a training exercise explosion in 2007, has been making good progress since his March 14 surgery.
Although it is still early, Mr. Kepner also is doing well, Dr. Lee said, and has shown no signs of rejection.
In a little over a week, he will get an infusion of bone marrow cells from the donor as part of a technique known as the Pittsburgh Protocol that is designed to help his body accept the new hands.
Mr. Maloney's amputation was at his wrist, and so he is expected to gain feeling and movement in the transplanted hand sooner than Mr. Kepner, whose amputations were both at the mid-forearm level.
In a transplanted hand, the nerves grow from the recipient into the new tissue at a rate of about one inch per month, Dr. Lee said, so Mr. Kepner's sensation is not likely to occur until nine months to a year from now.
Mrs. Kepner said her husband is upbeat, which is the same attitude that has sustained him since the time of his amputations.
During his Air Force career, Mr. Kepner was extremely athletic, she said.
Ten years ago this month, he woke up one Monday feeling flu symptoms. He didn't see a doctor until the following Friday, and was told he probably did have the flu, she said, but the next day, he was having trouble breathing and she took him to the emergency room.
His condition deteriorated rapidly, and doctors did not know what was wrong until a full-body scan showed an enlargement on his liver, which turned out to be a pocket of tissue filled with Streptococcus A bacteria.
For the next three weeks, he lay in an induced coma as he fought to survive. During that time, his body shunted his blood to his organs and cut off flow to his extremities, she said. By the time he awoke three weeks later, his hands and feet had turned black and amputations were unavoidable.
Since then, she said, he has learned how to use hook prostheses for his hands, and to walk on leg prostheses that consist of titanium rods attached to lifelike feet.
He has had both hips replaced in that time, too, because of damage from steroids during his original treatment.
Mrs. Kepner said they were persuaded to join the experimental trial at UPMC partly because it is designed to keep immunosuppressive medications at the lowest possible level. That's important because such medications, which are needed to keep the body from rejecting the new tissue, can lead to infections, cancer, kidney damage and other problems.
The other motivating factor was the support they have received from their church, Burns Memorial United Methodist Church in Augusta.
"The faith and prayers we've received from our church have been a powerful thing and it's been the foundation of our lives."
Mark Roth can be reached at email@example.com or at 412-263-1130.