LONDON: Hand transplants are to be performed on the health service for the first time.
A specialist centre in Leeds has been given the go-ahead to assess patients and start performing the highly complex surgical procedure from April.
The move follows a three-year study examining the potential for transplants funded by the health service.
The first hand transplant in Britain was performed in 2012 on former pub landlord Mark Cahill, who now has significant use of his hand and is able to tie his shoelaces and drive a car.
Four patients have already been identified to have a transplant, of which two have been fully evaluated with donors being sought.
Consultant plastic surgeon Professor Simon Kay, who operated on Cahill, will run the transplant programme in Leeds.
He said: "There have been lots of hand transplants around the world but this is the first time a national funding organisation has closely examined the issue, come up with the conclusion that it's worth pursuing and is now going to fund it nationally in one centre."
He said it was unlikely more than one or two procedures would be carried out each year, but promised to "meet the need".
Those eligible for the operation will typically have lost one or both hands, mainly below the elbow.
They may have suffered injuries caused by machinery such as chainsaws, or had the life-threatening infection sepsis which is the commonest cause of hand loss, according to Prof Kay.
NHS Blood and Transplant will work closely with the team in Leeds to identify possible donors.
The search will initially be limited to Yorkshire and the North due to the need for the donor limb to be taken quickly to the recipient in order for it to function.
However, this could be extended across the UK in the future.
The emphasis will be on matching blood group, skin tone and hand size.
The option to donate limbs is not recorded on the NHS Organ Donation Register, so specific permission will be sought from the families of potential donors after their death.
All patients will be carefully screened for psychological and physical suitability.
The procedure, which can last up to 12 hours, involves four teams of surgeons working simultaneously.
During the operation, the two bones in the upper arm are attached to each other with titanium plates and screws.
Surgeons then connect key tendons and muscles, before blood vessels - including the two main arteries in the upper arm - are connected.
Once blood is circulating to the limb, remaining nerves, tendons and muscles are attached.
It is estimated the operation costs £50,000, and up to £3,000 a year after that in rehabilitation and immuno-suppressant drug costs.
Cahill, from West Yorkshire, has regained almost complete use of his transplanted hand.
He said: "My experience as a patient and my quality of life since the hand transplant has been fantastic.
"I would like to thank once again the family of the donor who gave their permission for me to have the hand of their relative at such a difficult time for them. It really has transformed my life".
Around 80 hand transplants have been performed worldwide.