A team of surgeons at Keck Medicine of USC and UCLA Health completed the world’s first human bladder transplant May 4, paving the way for a new standard of care for patients with non-functioning or “terminal” bladders.
The procedure was performed in combination with a kidney transplant on a male patient who had been dependent on dialysis for seven years, according to a news release from the Los Angeles-based health systems. Several years ago, the patient had most of his bladder removed during a surgery to remove cancer. Both of his kidneys had also previously been removed due to renal cancer.
During the eight-hour procedure, surgeons first transplanted the kidney, followed by the bladder. After the surgery, the kidney began functioning immediately, producing urine that drained properly into the new bladder. The patient has not required dialysis since the procedure and has been recovering well, according to his medical team.
“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,” Inderbir Gill, MD, founding director of USC Urology, said in the release. Dr. Gill co-led the procedure with Nima Nassiri, MD, a urologic transplant surgeon and founding director of the UCLA Vascularized Composite Bladder Allograft Transplant Program.
Over the past four years, Dr. Gill and Dr. Nassiri have worked together to develop the surgical technique, design a clinical trial and secure regulatory approvals. They performed several preclinical practice surgeries, including robotic bladder retrievals and transplants in five deceased donors at Keck Medical Center.
Experts say bladder transplantation could offer an alternative to current reconstructive surgeries, which typically use intestinal segments to create a urinary reservoir. These procedures carry long-term risks, including recurring infections, compromised kidney function and gastrointestinal issues. A transplanted bladder restores a more natural urinary reservoir and may help reduce the risks associated with traditional methods, according to medical experts.
