Latest news with #NimaNassiri
The Guardian
19-05-2025
- Health
- The Guardian
Surgeons in California perform first ever successful bladder transplant
Surgeons in California have performed the first ever successful bladder transplant, aiding a patient who previously had his bladder and both kidneys removed as a result of cancer treatment and end-stage kidney disease. The treatment allowed the patient, 41-year-old father of four Oscar Larrainzar, to go off dialysis – although the surgery comes with considerable short- and long-term risks and unknowns. The bladder transplant was done by two surgeons who worked for years to develop the technique, which was used to transplant one kidney and a bladder recovered from a human donor. '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 Dr Inderbir Gill, the executive director of the University of Southern California Institute of Urology, and one of two surgeons who worked on the case, according to a press release. 'Transplantation is a life-saving and life-enhancing treatment option for many conditions affecting major organs, and now the bladder can be added to the list.' Gill performed the surgery with Dr Nima Nassiri of the University of California Los Angeles (UCLA) Institute of Urgology. 'This first attempt at bladder transplantation has been over four years in the making,' Nassiri said, in a statement. 'For the appropriately selected patient, it is exciting to be able to offer a new potential option.' Patients who have their bladder removed most often have a portion of intestine repurposed to pass urine, often resulting in a host of new complications, including infections and digestive issues. Those complications have led doctors around the world to seek bladder transplant techniques for years. The transplant performed in early May has so far succeeded, and doctors said they are 'satisfied' with Larrainzar's recovery, though many unknowns remain. For instance, how Larrainzar's new bladder will function over time and how long he will need to be on immune suppression medication to prevent rejection of the organ. Sign up to Headlines US Get the most important US headlines and highlights emailed direct to you every morning after newsletter promotion The doctors plan to perform more bladder transplants as part of a clinical trial at UCLA Health, with the goal of better understanding potential complications and helping patients who suffer debilitating bladder conditions.
New York Post
19-05-2025
- Health
- New York Post
World's first bladder transplant performed in the US: ‘Now I have hope'
Urine for a breakthrough — in a true medical milestone, UCLA surgeons completed the world's first in-human bladder transplant. Dr. Nima Nassiri, a urologic transplant surgeon and director of the UCLA Vascularized Composite Bladder Allograft Transplant Program, led the stream team — providing relief to one lucky patient who had been struggling for years after having most of his bladder removed due to a tumor. 3 The first human bladder transplant was performed at UCLA on patient Oscar Larrainzar. Nick Carranza/UCLA Health 'I was a ticking time bomb,' Oscar Larrainzar, 41, told the New York Times. 'But now I have hope.' The groundbreaking eight-hour operation — performed on May 4 at Ronald Reagan UCLA Medical Center — involved extensive research, practice surgeries on animals and deceased donors and the development of new surgical techniques. 'This first attempt at bladder transplantation has been over four years in the making,' Nassiri said in a statement. 'For the appropriately selected patient, it is exciting to be able to offer a new potential option.' Bladder transplants had not been attempted before due to the complex vascular structure of the pelvic area and the technical challenges involved. Current treatments for non-functioning bladders often involve using a segment of the patient's intestine to create a urinary reservoir, which can lead to complications like infections and digestive issues. 3 The team was led by Dr. Nima Nassiri, left, a urologic transplant surgeon. Nick Carranza/UCLA Health 3 The surgery was performed at Ronald Reagan UCLA Medical Center on May 4, 2025. Nick Carranza/UCLA Health While the long-term success of the transplanted bladder remains to be seen, Larrainzar's overnight recovery has been promising. '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.' The team aims to perform more of these pioneering surgeries in the near future, offering fresh hope to patients with non-functioning bladders. And this is not the only groundbreaking transplant in recent months. Earlier this year, a 'miracle' baby girl was born in the UK to a mom who had undergone a womb transplant. And doctors at NewYork-Presbyterian performed an extremely rare series of heart transplant surgeries that transformed the lives of three children.
The Sun
19-05-2025
- Health
- The Sun
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 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. I haven't peed in SIX YEARS and never will again - I live in constant agony and it could kill me '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.' Organ transplants currently available Organ transplants, which replace failing or damaged organs with healthy ones from donors, are now available for a variety of organs. They've become possible due to advancements in surgery, medicine (including immunosuppressant drugs), and a better understanding of the donor process. Available organs include: Kidneys: The most commonly transplanted organ, helping patients with end-stage kidney disease. Liver: Treats various liver diseases, including cirrhosis and liver cancer. Heart: Addresses heart failure and other heart conditions. Lungs: Treats conditions like cystic fibrosis, pulmonary fibrosis, and other lung diseases. Pancreas: Transplants are used to treat diabetes and some pancreatic cancers. Intestine: Transplants are performed for patients with severe gastrointestinal disorders. 3
New York Times
18-05-2025
- Health
- New York Times
Surgeons Perform First Human Bladder Transplant
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 earlier this month by a pair of surgeons from the University of California, Los Angeles, 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, Oscar Larrainzar, said on Thursday 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 to get a sense of outcomes like bladder capacity and graft complications before pursuing a larger trial to expand its use. Dr. Inderbir Gill, who performed the surgery along with Dr. Nima Nassiri, called it 'the realization 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, the chairman of the urology department at U.S.C. Pushing the Envelope Until now, most patients who undergo a bladder removal have a portion of their intestine repurposed to help them pass urine. Some receive an ileal conduit, which empties urine into a bag outside the abdomen, while others are given a so-called neobladder, or a pouch tucked inside the body that attaches to the urethra and allows patients to urinate more traditionally. 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 percent of patients, ranging from electrolyte imbalances to a slow reduction in kidney function. The loss of the intestinal segment can also cause new digestive issues. Dr. Despoina Daskalaki, a transplant surgeon at Tufts Medical Center who was not involved in the new procedure, said advances in transplant medicine (from critical life-sustaining organs, like hearts and livers, to other body parts, like faces, hands, uteri and penises) had led doctors to start 'pushing the envelope.' 'They're asking: 'Why do we have to put up with all the complications? Why don't we try and give this person a new bladder?'' Dr. Daskalaki said. In late 2020, Dr. Nassiri was in his fourth year of residency at the University of Southern California when he and Dr. Gill sat down in the hospital cafeteria to begin brainstorming approaches. After Dr. Nassiri began a fellowship on kidney transplantation at U.C.L.A., the two surgeons continued working together across institutions to test both robotic and manual techniques, practicing first on pigs, then human cadavers, and finally, human research donors who no longer had brain activity but maintained a heartbeat. One of the challenges of transplanting a bladder was the complex vascular infrastructure. The surgeons needed to operate deep inside the pelvis of the donor to capture and preserve a rich supply of blood vessels so the organ could thrive inside the recipient. 'When we're removing a bladder because of cancer, we basically just cut them. We do it in less than an hour on a near-daily basis,' Dr. Gill said. 'For a bladder donation, that is a significantly higher order of technical intensity.' The surgeons also chose to conjoin the right and left arteries — as well as the right and left veins — while the organ was on ice, so that only two connections were needed in the recipient, rather than four. When their strategy was perfected in 2023, the two drew up plans for a clinical trial, which eventually would bring the world's first recipient: Oscar. An Ideal First Candidate When Oscar Larrainzar, walked into Dr. Nassiri's clinic in April 2024, Dr. Nassiri recognized him. Almost four years earlier, Mr. Larrainzar, a husband and father of four, had been navigating end-stage kidney disease and renal cancer, and Dr. Nassiri helped remove both of his kidneys. But Mr. Larrainzar had also survived urachal adenocarcinoma, a rare type of bladder cancer, and a surgery to resect the bladder tumor had left him 'without much of a bladder at all,' Dr. Nassiri said. A normal bladder can hold more than 300 cubic centimeters of fluid; Mr. Larrainzar's could hold 30. Now, years of dialysis had begun to fail; fluid was building up inside his body. And with so much scarring in the abdominal region, it would have been difficult to find enough usable length of bowel to pursue another option. 'He showed up serendipitously,' Dr. Nassiri said, 'but he was kind of an ideal first candidate for this.' On a Saturday night earlier this month, Dr. Nassiri received a call about a potential bladder match for Mr. Larrainzar. He and Dr. Gill drove straight to the headquarters of OneLegacy, an organ procurement organization, in Azusa, Calif., and joined a team of seven surgeons working overnight to recover an array of organs from a donor. The two brought the kidney and bladder to U.C.L.A., then stopped home for a shower, breakfast and a short nap. They completed the eight-hour surgery to give Mr. Larrainzar a new bladder and kidney later that day. Dr. Nassiri said that kidney transplants can sometimes take up to a week to process urine, but when the kidney and bladder were connected inside Mr. Larrainzar, there was a great connection — 'immediate output' — and his creatinine level, which measures kidney function, started to improve immediately. Mr. Larrainzar has already lost 20 pounds of fluid weight since the surgery. The biggest risks of organ transplantation are the body's potential rejection of the organ and the side effects caused by the mandatory 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 Mr. 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. 'A Miracle' A new bladder transplant also does not have nerve connections in the recipient, so while it works well as a storage organ, doctors did not know whether Mr. Larrainzar would ever be able to sense a full bladder, let alone hold and empty it naturally. They spoke about catheters, abdomen maneuvers and eventually developing an on-demand bladder stimulator to help with the release. But at a follow-up appointment on Thursday morning — just two days after Mr. Larrainzar was discharged from the hospital — Dr. Nassiri removed the catheter and gave him fluids, and Mr. Larrainzar immediately felt that he could urinate. Dr. Nassiri called it a miracle, then phoned Dr. Gill, who was in a U.S.C. operating room, and exclaimed two words: 'He peed!' 'No way! What the hell?' Dr. Gill said. 'My jaw is on the floor.' After finishing the surgery, Dr. Gill drove straight to U.C.L.A. and watched Mr. Larrainzar do it again. 'Of course, this is very, very early. Let's see how everything goes,' Dr. Gill cautioned. 'But it's the first time he has been able to pee in seven years. For all of us, this is huge.' Mr. Larrainzar, exhausted, smiled, and Dr. Nassiri brought him a bottle of mineral water to celebrate.
