(CNN) -- The following is an edited transcript of a chat conducted Friday, January 29, 1999 with Dr. John Barker, one of the surgeons who helped perform the first hand transplant in the United States.

Dr. Barker: I'm excited to be here the first day after the transplant surgery. Our website received 100,000 hits so I know people are interested in this topic.

Chat Participant: Welcome Dr. Barker - where did the hand that you used come from?

Dr. Barker: The hand was from a donor who also donated organs. It was a brain dead, heart-beating donor.

Chat Participant: I'd like to know how you are doing with sensory nerve regeneration?

Dr. Barker: The sensory nerve regeneration would be similar to a replant, in which a hand is replanted after amputation.

Chat Participant: Is it very difficult to reattach nerves? Will the hand eventually have any feeling?

Dr. Barker: Many different components have to be reattached - bone, nerves, blood vessels, tendons, skin, muscle. Of those, the nerves are not one of the most particularly difficult. Probably the blood vessels, the veins, are the most difficult.

Chat Participant: Dr. Barker, has your team received much criticism for this hand transplant operation? What has the response been?

Dr. Barker: Generally we've had good response. We have, however, received criticism from different sectors, as is the case with any new surgical procedure.

Chat Participant: How many years of research went into this?

Dr. Barker: Of our own research, local research, it has been three years. All medical scientific research is built on the work of other researchers. Our research was primarily done in animals, different species of animals. Lately, the most recent that led us up to doing it in humans was in pigs.

Chat Participant: The patient, Scott, has diabetes. Was your team hesitant to do the operation because of this? Does it make the procedure more dangerous in the long run?

Dr. Barker: No. It was a consideration. However, based on advice from our transplant surgeons who are the ones that are managing the patient's immunosuppression they felt that it was not a problem.

Chat Participant: Dr. Barker, is it true the hand transplant recipient may actually be harmed by the transplant since he has diabetes?

Dr. Barker: No. That is not true.

Chat Participant: What anti-rejection drugs are you using? Names? Dosages?

Dr. Barker: It is a therapeutic protocol known as combination therapy. In this particular protocol, we are using low doses of FK506, MMS and Prednizone.

Chat Participant: How long did the operation take?

Dr. Barker: The operation took about 12 hours. First, we identified a donor. At that time, the patient was notified and was brought to Louisville. At the same time, the surgical team was notified. And, at the same time, a team from Louisville was sent to procure the hand.

Chat Participant: Is it the same type of organ harvesting team that would harvest for hearts, etc?

Dr. Barker: They went on the same airplane, they accompanied the organ procurement team, but it was a new team of hand surgeons.

Chat Participant: Is there any protocol in place for the recipients to know about the donors, like can happen currently with kidneys or livers?

Dr. Barker: We are utilizing the exact same protocol used for organ donation. In fact, it's the same organization that facilitated and organized the procurement of the hand. The Organization is KODA, Kentucky Organ Donor Association.

Chat Participant: Did the donor's family have to approve of the donation?

Dr. Barker: In Kentucky your donation is for organs and tissues, so, yes, the hand would be included. However, since this is a new procedure, we are very careful to notify and to get approval from the loved ones or the family of the donor.

Chat Participant: Dr. Barker, what are the actual chances that he will gain sensation in his new hand?

Dr. Barker: Because of the age of the patient, he will probably have better chances than if it were an older patient. However, that sensation will not be real fine sensation. This is all from our experience in replantation, where a severed limb is reattached.

Chat Participant: Dr. Barker, how much do hospitals charge a transplant patient for a kidney?

Dr. Barker: It's very difficult to say what the cost will be for the hand, because it is still in its experimental stage. However, we calculate that the cost when this is done widespread will be similar to that of a kidney transplant. And that is about $100,000 and then about $2,000 a month maintenance after that. That's for a lifetime for the anti-rejection drugs. Insurance was actually covering the cost in this particular patient of the maintenance drugs. Everything else was covered by the Jewish hospital where the transplant took place. And all of the professionals donated their time.

Chat Participant: What are the long-term effects of taking anti-rejection drugs. Will the patient need to take them for the rest of his life?

Dr. Barker: Yes, the patient will take the anti-rejection drugs for the rest of his life. The risks associated with immunosuppressant drugs are three major ones. One, increased susceptibility to infection. Two, an increased risk of certain types of cancer. And, lastly, some metabolic disorders.

Chat Participant: Shouldn't people be able to sell their own organs? And wouldn't that increase the supply of livers?

Dr. Barker: This is my opinion only, but no. People should not be able to sell their organs. In terms of improving the donor supply, education is essential to the public. This is not a problem for hand transplant yet, but for organ transplantation, it is the major problem. There are about 10,000 people in the United States waiting for hearts at this moment.

Chat Participant: Do you think a person should be able to choose to have a procedure that may also carry risks?

Dr. Barker: I think absolutely. Without these types of experimental procedures, there would be no advance of medicine. This is called informed consent, and it is one of the most complex parts of all the work we've done leading up to this, namely the patient must be informed about all of the risks associated with all new procedures. Just because a patient says that he or she understands that doesn't always mean he or she does. So, it is very important that the physician and the team know the patient very well.

Chat Participant: Dr. Barker, does your team have any more transplant surgeries planned in the near future?

Dr. Barker: Yes, we have about three patients that we are looking at now. We have approval to do ten. The Institutional Review Board at our hospital, the IRB, has approved that we do ten. At which time, we would look back and review what we've done, and then decide to proceed on or not. The ten are all hand transplants.

Chat Participant: All I am seeing is talk about the risks. What are the benefits?

Dr. Barker: Good point. Most of our work focuses on the risks. All you have to do is speak to an individual who is missing a hand or hands and it's immediately apparent what the benefits are. Imagine not having two hands, like many of our patients, where you can't dress yourself, you can't eat by yourself, you can't even clean yourself after going to the bathroom. Your quality of life is low at best. This patient had one hand, but we have some patients we are considering who have both hands missing. The previous patient we were considering had both hands missing, but we ended up not doing the transplant on him.

Chat Participant: So this patient wanted this procedure?

Dr. Barker: We have a transplant psychiatrist and every patient is thoroughly evaluated to make sure that he or she really wants it, because only this type of patient will be compliant and assure the best possible outcome.

Chat Participant: I've grown up with news about liver and heart transplants. Why is a hand transplant so significant? Is it any more difficult?

Dr. Barker: It's not more difficult. The most difficult part of a hand transplant is the rejectability of the skin. All of our tissues have a different degree of rejectability or anti-genicity and of all of the tissues, skin is the most antigenic. This is because one of the important functions of the skin is its function as a barrier to the outside environment. This function serves to protect the organism from outside foreign bodies. The reason we are able to do a hand transplant now is because of the availability of modern immunosuppressant drugs. The drugs effects are very strong anti-rejection and relatively low systemic toxicity.

Chat Participant: Doctor, I read the young man will be more limited with the transplant than prosthesis? Is that true?

Dr. Barker: With the prosthesis, you can't button a shirt, and you can't feel anything.

Chat Participant: Dr. Barker, the idea of transferring body parts is somewhat daunting. It makes me think of Frankenstein or worse, Saturday morning cartoons. Is it reasonable to be wary of this or even downright scared of it?

Dr. Barker: I think to put it in context, you need to know an individual who is missing one of these body parts, and thus realize what it means to that person to have a body part they were missing. Donors usually die in an accident or something, where they are brain dead, and are kept alive on machines until the organs are harvested. The tissue is alive, but the person has been declared brain dead.

Chat Participant: Wasn't this done to further medical research and not for the "man without a hand?"

Dr. Barker: We're first medical doctors. And second, scientists. So it was done first for the patient.

Chat Participant: Doctor, wouldn't the money be better spent to allow this person to deal with his handicap and use the available prosthesis, or explore a more creative prosthesis?

Dr. Barker: That is being worked on. In fact, we probably would not consider doing a foot transplant because the prostheses that are available for lower extremities are excellent. So the risk posed by the immunosuppressant drugs would not justify the benefits.

Chat Participant: But a creative prosthesis is not nearly so dramatic. Certainly doesn't get the PRESS this did.

Dr. Barker: But we're not prostheists, we're surgeons. From a surgeon's standpoint, absolutely.

Chat Participant: Dr. Barker, do you feel the heart transplant from a baboon to Baby Fae was done with the interests of the baby in mind?

Dr. Barker: If it had worked, it would have revolutionized transplant surgery.

Chat Participant: Dr.Barker, do the hands look alike? Size, skin color, etc.?

Dr. Barker: Within certain parameters, there are three large criteria in terms of hand transplantation. One is the aesthetic appearance of the hand, color, and hair distribution. That is left up to the patient, the recipient. Other considerations are medical and these deal with the immunology of the patient, the psychological aspects of the patient, and finally, there are some simple mechanical considerations in terms of bone size, and these are just that the hand has to be of similar size or it ‘won't fit’.

Chat Participant: What will be the extent of feeling in the hand? Touch, pressure, pain, temperature?

Dr. Barker: It would only be judged by experience in replantation surgery, and it will not have full sensation. Again, that's from our experience with replantation. The surgery is complex, with ten doctors involved, including the procurement team. However, any major hand surgery center in the country and abroad could do this. Remember that prior to doing this procedure, hand surgeons have had between 25 and 30 years of experience reattaching hands.

Chat Participant: Have you had a great deal of protests on this surgery?

Dr. Barker: We've had protests, but I would say by and far, it's been mainly positive response, and again, this is typical of any new procedure.

Chat Participant: Dr. Barker, has your team been following the progress of the surgical team in France that also did a hand transplant? Are you in contact with them at all?

Dr. Barker: Yes, they used the exact same drug regiment as we are using, so we are very interested to follow the progress of the patient in France.

Chat Participant: What do you see for the future of transplantation?

Dr. Barker: If we are successful with our first hand transplants, successful meaning that we have a good return of function, and minimal systemic toxicity to the patient, then transplantation of other body parts that contain skin, muscle, bone, arteries, nerves, veins, will then be possible.

Chat Participant: Dr. Barker, what were any ethical concerns, if any, that would be against doing the transplant?

Dr. Barker: Some people think that the risks posed by the immunosuppression drugs outweigh the benefits of having a new hand. However, most of these individuals have two normal hands.

Chat Participant: Is there a difference in races when it comes to transplants?

Dr. Barker: There are no racial indications that we are aware of that would make you a better or worse patient.

Chat Participant: Do you agree with the proposed idea that the potential donors should be able to sell their organs before they die?

Dr. Barker: I believe I already mentioned that I am personally opposed to the idea of people being able to sell their organs. However, I do believe there is a great need for increased education and therefore, more donors. Any donor organization or anybody doing transplantation is always trying to pitch the necessity for donor awareness. One of the main reasons we had a press conference on this way back last year when we got IRB approval from our hospital, was to educate the public and potential donors, the families of donors, or potential donors themselves.

Chat Participant: Dr. Barker are you an organ donor, have you signed a card AND informed your family?

Dr. Barker: Absolutely, but not my hands. Just kidding. What about the rest of you? Has everyone here signed their organ donor card?

Chat Participant: Dr. Barker, if Matthew Scott's transplant fails over the next few months, what happens to the research from there?

Dr. Barker: Depending on the reason for failure, we will either change our procedure or continue on. It is very difficult to make decisions based on one transplant. That is why they initially approved ten.

Chat Participant: How long does it have to heal before he can try using the new hand?

Dr. Barker: That progresses over the first year. The reason we don't have him move it extensively initially is because all of the tissues that we sewed together have to heal. And similar to when you get your stitches out from a wound, that can take from ten days to three months to heal.

Chat Participant: Is this transplant seen as a success?

Dr. Barker: So far, we consider the surgery a success. We define success at this point in the fact that the hand is healthy, with good blood flow, and there are no signs of rejection. At six months, success will be defined differently. There we hope to have motion, function and finally at one year, we hope to have much more function. However, we do not expect that the function will ever return to 100%. He will have difficulty with buttons, perhaps not be able to pick up a dime.

Chat Participant: If the hand is rejected, do you plan on repeating the procedure? Do you have more available hands?

Dr. Barker: Yes, depending on the reason for rejection. Please remember that this procedure is still experimental.

Chat Participant: Does such a transplant have to be approved on a national level?

Dr. Barker: No, because there is no new device or new drugs. The FDA approves devices and pharmaceuticals. This is simply a new surgical procedure.

Chat Participant: What about the media attention?

Dr. Barker: The media attention has been very positive. We have worked very closely with the media. As another example, prior to our initial press conference at the time of our IRB approval, we had eight potential candidates for transplant. One month after the press release, we had 100. Therefore, thanks to that press conference, we were able to select from a large population of amputees and therefore select ideal candidates.

Chat Participant: Has there been any resistance?

Dr. Barker: The major resistance has been from hand surgeons. Some hand surgeons believe that the risks of the anti-rejection drugs do not justify the benefits received by a new hand. This is an ongoing experiment, and we are now ready to do the next surgery, as soon as there is a donor hand available. You can read more about it at http://www.handtransplant.com. The information available is the research done leading up to this, the bios of the research team, and regularly updated progress of the patient.