A craftsman has sacrificed his big toe in the hope of having a working thumb.
James Byrne agreed to undergo the rare toe-to-thumb transplant at a British hospital so that he might be able to return to life as a paver.
The 29-year-old, originally from Carlow, chopped into his left thumb last December while sawing wood.
The thumb was severely damaged and doctors initially recommended plastic surgery.
Surgeon at Frenchay Hospital, Umraz Khan, tried to re-attach it, but the op failed.
"Mr Khan re-attached my thumb but it had been badly damaged and although we tried everything, including leeches, to get the blood flowing again it didn't take," said Mr Byrne.
The doctors agreed that the next best option was to take the toe from his left foot and attach it to his hand.
As a paver, the loss of a toe was considered less restricting than the thumb.
Mr Byrne, who has an eight- year-old son, Connor, said he thought Mr Khan was joking when he first suggested amputating his toe. Before the toe operation on September 8, he had tried to go back to work paving and realised he couldn't cope.
"I couldn't lift anything with my left hand. You can't lay one-handed, you might as well go home," he said.
He said that almost a week after the eight-hour operation, the new digit looked "like a cartoon thumb that has been hit by a mallet". However he added: "The aesthetics don't bother me, I am just happy that it works."
And while the pain of losing his thumb was excruciating, he is experiencing little discomfort from his left foot, he said.
Mr Byrne will now have physiotherapy to help him to adapt and he expects to be back at work in a few months.
The construction worker left the village of Rathvilly in Co Carlow when he was just seven years of age, after his parents Margaret, nee Cullen, and Joseph Byrne decided to emigrate with their four children.
Many of his relatives still live in Carlow and he is planning a trip back at Christmas.
Mr Khan led two teams of surgeons and anaesthetists in Bristol -- one working on Mr Byrne's toe while the other worked on his hand.
He said: "It is a very complex micro-surgical procedure which involves re-attaching the bone, nerves, arteries, tendons, ligaments and skin.
"James will have to learn to re-balance, without his left great toe, on to the ball of the foot but he will be able to walk and jog.
"The thumb is the dominant digit. Without it, James would not be able to do the things that we take for granted, like holding a pen or opening a door.
"The loss of the great toe is not as disabling as losing a thumb, so the loss far outweighs the gain."