US surgeons perform first human bladder transplant

Straits Times

20-05-2025

Dr Inderbir Gill (left) who performed the surgery along with Dr Nima Nassiri, with the patient, Mr Oscar Larrainzar, who had a rare form of bladder cancer. PHOTO: UCLA HEALTH/FACEBOOK
LOS ANGELES – Surgeons in Southern California have performed the first human bladder transplant, introducing a new, potentially life-changing procedure for people with debilitating bladder conditions.
The operation was performed this month by a pair of surgeons from UCLA and the University of Southern California on a 41-year-old man who had lost much of his bladder capacity from treatments for a rare form of bladder cancer.
'I was a ticking time bomb,' the patient, Mr Oscar Larrainzar, said on May 18 during a follow-up appointment with his doctors. 'But now I have hope.'
The doctors plan to perform bladder transplants in four more patients as part of a clinical trial before pursuing a larger trial.
Dr Inderbir Gill, who performed the surgery along with Dr Nima Nassiri, called it 'the realisation of a dream' for treating thousands of patients with crippling pelvic pain, inflammation and recurrent infections.
'There is no question: A potential door has been opened for these people that did not exist earlier,' said Dr Gill, also chair of the urology department at USC.
Until now, most patients who undergo a bladder removal have a portion of their intestine repurposed to help them pass urine.
But bowel tissue, riddled with bacteria, is 'inherently contaminated,' Dr Gill said, and introducing it to the 'inherently sterile' urinary tract leads to complications in up to 80 per cent of patients.
Mr Larrainzar, whose kidneys had both been removed almost four years earlier, also received a kidney transplant. Dr Nassiri said that kidney transplants can sometimes take up to a week to process urine, but that when the kidney and bladder were connected inside Mr Larrainzar, there was 'immediate output,' and his creatinine level, which measures kidney function, started to improve immediately.
The biggest risks of organ transplantation are the body's potential rejection of the organ and the side effects caused by the immune-suppressing drugs given to prevent organ rejection. That is why, for Dr Rachel Forbes, a transplant surgeon at Vanderbilt University Medical Center who was not involved in the procedure, the excitement is more tempered.
'It's obviously a technical advance,' she said, but 'we already have existing options for people without bladders, and without the downside of requiring immunosuppression.' Unless a patient is – like Larrainzar – going to be on those medications anyway, 'I would be a little bit nervous that you would be exchanging some complications for others,' she said. NYTIMES
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