LOUISVILLE, Ky. (Jan. 23) - Even after five years, Matthew Scott remembers the exact moment he woke to find he had fingers on his left hand again.

Doctors had attached a hand from a cadaver to Scott, whose own hand had been blown to bits in a fireworks accident 13 years earlier.

"Instead of a bulk of bloody bandages with nothing there, it was a bulk of bandages with fingers sticking out," said Scott, who lives in Camden, N.J. "I'll never forget that."

Scott, the first person in the world to enjoy long-term success after a hand transplant, is doing better than either he or the doctors who performed the surgery expected.

The surgery at Jewish Hospital in Louisville was controversial. Doctors and medical ethicists expressed concerns about whether enough research had been done into transplanting a hand and exposing such patients to potentially life-threatening anti-rejection drugs.

Since Scott's operation, 24 hands have been transplanted around the world to 18 people. Six of those transplants involved people who lost both hands. Two attempted transplants have failed, including the only one done before Scott's.

Scott's only significant complication has been arthritis in the thumb, a possibility doctors were aware of before the transplant. It become an issue only because Scott gained so much flexibility in the hand, said Dr. Warren Breidenbach, of Kleinert Kutz Hand Center in Louisville, who took part in attaching the hand.

Attaining so much function wasn't easy, said Scott, whose left hand is dominant. The initial physical therapy was intense - six days a week. It has since been scaled back to one day every other week.

The anti-rejection drugs, which suppress the immune system so his body won't attack the hand, have also been reduced.

The hand also has gained nerve sensation, enabling Scott to feel hot, cold, pain and, to an extent, discriminate between rough and smooth surfaces.

"I've returned to doing a lot of the everyday tasks I was not able to do with the prosthesis," Scott said.

"My goal is to make this last as long as possible," he said. "With every success we do in the early ones, that means there's more opportunity for people after me to have this type of surgery."

01/23/04 23:10 EST