The world's first double leg-transplant patient has had his legs amputated, a Spanish hospital has confirmed.
The amputation was carried out after an unrelated illness forced the man to stop taking anti-rejection drugs, according to Valencia's Hospital La Fe.
The hospital said treatment of the unspecified illness was "more urgent".
The transplant was carried out in July 2011 by surgeon Pedro Cavadas, who also led a team that carried out the first double hand transplant in 2006.
The man who received the double leg transplant, who was in his 20s at the time and has not been named, initially lost his legs above the knee in a road accident.
Mr Cavadas and his team of more than 50 at Hospital La Fe took more than 10 hours to attach the new legs, a procedure that included connecting nerves, blood vessels, muscles, tendons and bone structure.
The patient was expected to take immuno-suppressant drugs for the rest of his life, but had to stop because the medicine was complicating the treatment of an illness he contracted, doctors said.
"In these cases the protocol is that, if the transplanted organ is not a vital organ, it should be removed from the patient so as to allow treatment of the illness that is more serious and urgent," the hospital said in a statement.
Mr Cavadas is referred to as a "miracle doctor" by parts of the Spanish media for his pioneering procedures.