World’s first bladder transplant marks ‘historic moment’ as man, 41, able to pee again for first time in 7 years

SURGEONS have performed the first-ever human bladder transplant - a game-changing procedure with the potential to help thousands living with deadly organ failure.

The first person to undergo the operation is 41-year-old Oscar Larrainzar, a father of four who had previously lost most of his bladder during a tumour removal process.

3

3

The remainder of his bladder was too small to work and both his kidneys were subsequently removed due to cancer and end-stage kidney disease.

He'd been on dialysis for seven years.

The complex procedure carried out by surgeons from UCLA Health and Keck Medicine of USC involved the transplantation of both a new bladder and a new kidney, recovered from a donor, and lasted approximately eight hours long.

UCLA urologic transplant surgeon Dr Nima Nassiri and Dr Inderbir Gill, assisted by a surgical team, said the results were quickly evident.

“The kidney immediately made a large volume of urine, and the patient’s kidney function improved immediately,” Nassiri said.

“There was no need for any dialysis after surgery, and the urine drained properly into the new bladder.”

“Despite the complexity of the case,” Gill said, “everything went according to plan and the surgery was successful.

"The patient is doing well, and we are satisfied with his clinical progress to date.”

It's not known how well the transplanted bladder will function over time and how much immunosuppression will be needed to prevent rejection of the transplanted organs.

But to date, Larrainzer has been stable.

“This surgery is a historic moment in medicine and stands to impact how we manage carefully selected patients with highly symptomatic ‘terminal’ bladders that are no longer functioning,” said Gill, who is also a distinguished professor and chair of urology at the Keck School of Medicine of USC.

“Transplantation is a lifesaving and life-enhancing treatment option for many conditions affecting major organs, and now the bladder can be added to the list.”

Bladder transplants haven't been carried out previously because of the complicated vascular structure of the pelvic area and the technical complexity of the procedure.

Current treatments include the replacement or augmentation of the urinary reservoir - a procedure that uses part of a patient's intestine to create a "new" bladder or a pathway for urine to exit the body.

While these surgeries can be effective, they come with many short-and long-term risks that compromise a patient's health, such as internal bleeding, bacterial infection and digestive issues.

“A bladder transplant, on the other hand,” Nassiri said, “results in a more normal urinary reservoir and may circumvent some short- and long-term issues associated with using the intestine.”

The procedure was performed as part of a UCLA clinical trial designed by Nassiri and Gill, who hope to perform more bladder transplants in the near future.

3