LOUISVILLE, Ky. -- Thirteen years after an explosive blew off his left hand, Matthew David Scott has a new one.

"He stares at it and grins," family friend James Brown said Monday as Scott, a paramedic from Absecon, N.J., recovered from the first hand transplant in the United States.The 14 1/2-hour surgery ended early Monday at Jewish Hospital in Louisville. His doctors said Scott, 37, was doing as well as possible. They watched closely for blood clots, other complications and any sign that the donor hand was being rejected.

"We don't expect to see rejection in the early phase. Our big concern is in the first three months," said Dr. Jon William Jones Jr., an organ rejection expert who was part of the surgical team.

A hospital spokeswoman said Tuesday there were no blood clots or other complications overnight.

"He is doing very well," Kim Freeman said. "He's alert. Everything is progressing as expected."

Tiny pieces of skin from the hand will be microscopically examined every few days to see if lymphocytes -- tissue-killing cells -- are attacking it, Jones said. If so, Scott's medication could be adjusted.

Scott was being given powerful drugs that reduce the chances of rejection but pose significant dangers of their own. His suppressed immune system makes him vulnerable to infections that could be life-threatening, said Jones and the lead surgeon, Dr. Warren Breidenbach.