Joseph Kutz, M.D., senior partner at Kleinert Kutz

Hand surgeon Joseph Kutz, M.D., senior partner at Kleinert Kutz, connects tendons from donor hand to recipient Dave Armstrong's arm at Jewish Hospital Hand Care Center on Saturday, July 12, 2008.

Warren Breidenbach, M.D., lead hand transplant surgeon

Lead hand transplant surgeon, Warren Breidenbach, M.D., prepares for hand transplant at Jewish Hospital Hand Care Center on Saturday, July 12, 2008.

(L-R) Ruben Gonzalez, M.D., Renato Botelho, M.D., Huey Tien, M.D., Tolga Turker, M.D. and Joseph Kutz, M.D., senior partner at Kleinert Kutz

Hand surgeons with Kleinert Kutz and the University of Louisville perform fourth hand transplant at Jewish Hospital Hand Care Center on Saturday, July 12, 2008.

Joseph Kutz, M.D., senior partner at Kleinert Kutz

Hand transplant as seen through the eyes of hand surgeon Joseph Kutz, M.D., senior partner at Kleinert Kutz.

(L-R) Ruben Gonzalez, M.D. and Warren Breidenbach, M.D., lead hand transplant surgeon

Ruben Gonzalez, M.D., and Warren Breidenbach, M.D., lead hand transplant surgeon, take time out to discuss next steps in the surgery with a team of surgeons with Kleinert Kutz and the University of Louisville at Jewish Hospital Hand Care Center on Saturday, July 12, 2008.

X-ray image of donor hand prior to being transplanted to recipient Dave Armstrong at Jewish Hospital Hand Care Center on Saturday, July 12, 2008.