Valarie Kepner's voice rose with excitement as she contemplated her husband, Jeff, with hands for the first time in 10 years.

"I just can't wait to see him," she said, laughing. "It will be cool."

The 57-year-old Augusta man was expected to be in surgery until late Monday or early today at University of Pittsburgh Medical Center to become the country's first double hand-transplant.

In May 1999, Mr. Kepner lost his hands and his feet to a bacterial infection that nearly killed him. Since late last year he has been undergoing testing to qualify for the transplant and was one of the first to complete all of the required testing, but the procedure required finding a suitable donor.

The family got the call Sunday morning and flew to Pittsburgh, Mrs. Kepner said.

"He's in surgery, and I'm just waiting for the next 20 hours," she said. A little more than four hours in, she had no word from the surgical team, but that is a good sign, she said.

"Everything so far, so good," Mrs. Kepner said Monday afternoon. "No news is good news at this point."

A later call to her cell phone Monday went to voice mail.

"He's still in surgery," Medical Center spokeswoman Amy Dugas Rose said early Monday evening. "He's expected to be there well into the evening."

A single hand transplant typically takes eight to 10 hours and a double hand transplant would add four to five hours, University of Pittsburgh transplant surgeons have said.

While there have been five single hand transplants in the U.S., and about a dozen double-hand-transplants worldwide, Mr. Kepner would be the first U.S. case.

The University of Pittsburgh is also using a novel anti-rejection protocol that involves giving Mr. Kepner a bone marrow transplant from the donor after the surgery to help his immune system develop tolerance to the new hands, and then using a single medication to help prevent rejection after that. Called the Pittsburgh protocol, it has been used successfully with organ transplants, surgeons said.

If the surgery goes well, Mr. Kepner is expected to stay in the medical center about a month, undergoing intensive rehabilitation to gain control of his new hands. That will continue for about three months on an outpatient basis with the Pittsburgh hospital.

Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.