The most obvious home function we associate with the bladder is plumbing. But transplanting a bladder is much more complex than reconnecting a replacement to existing pipes. It also requires attaching the organ to a complex network of veins located deep within the pelvic cavity. Then there’s the possibility of rejection by the immune system.
But a team of surgeons overcame these obstacles in the first-ever whole in-human bladder transplant. More accurately, it was a kidney-and-bladder transplant, since the patient had lost those organs, too, following cancer. Because he was already on immunosuppressive drugs, that reduced at least one risk. But the surgery itself was far from straightforward.
“This first attempt at bladder transplantation has been over four years in the making,” surgeon Nima Nassiri said in a press release. “For the appropriately selected patient, it is exciting to be able to offer a new potential option.”
First-Ever Bladder Transplant
Surgeons Nassiri, who specializes in urology transplants at the Ronald Reagan UCLA Medical Center, and Inderbir Gill, of USC Urology, first transplanted a donated kidney, followed by a bladder. Then they connected the two with a process they pioneered and practiced several times. The surgery lasted about eight hours. The surgeons saw almost instant improvement.
“The kidney immediately made a large volume of urine, and the patient’s kidney function improved immediately,” Nassiri said in a press release. “There was no need for any dialysis after surgery, and the urine drained properly into the new bladder.”
That success depended on time and innovation. The two surgeons developed the technique over several years. Then they designed clinical trials to test aspects of it and secured regulatory approvals.
Read More: The Origins of Organ Transplantation
Bladder Dysfunction and Future Treatments
They also needed practice. Before the actual transplant, Nassiri and Gill successfully completed the first-ever robotic bladder retrievals and successful robotic transplantations in five recently deceased donors whose cardiac functions were maintained by ventilators. They also removed several bladders without robotic support.
Current treatment for severe cases of bladder dysfunction or a bladder that has been removed includes replacing or extending of the urinary reservoir with a piece of the patient’s intestine. Risks in that approach include internal bleeding, bacterial infection, and digestive issues.
“A bladder transplant, on the other hand, results in a more normal urinary reservoir, and may circumvent some short- and long-term issues associated with using the intestine,” Nassiri said in the release.
If the first-ever bladder transplant recipient’s body continues to not reject his new organs and they continue to function, then the technique may become more common.
This article is not offering medical advice and should be used for informational purposes only.
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Article Sources
Our writers at Discovermagazine.com use peer-reviewed studies and high-quality sources for our articles, and our editors review for scientific accuracy and editorial standards. Review the sources used below for this article:
UCLA Health. First human bladder transplant performed at UCLA
Before joining Discover Magazine, Paul Smaglik spent over 20 years as a science journalist, specializing in U.S. life science policy and global scientific career issues. He began his career in newspapers, but switched to scientific magazines. His work has appeared in publications including Science News, Science, Nature, and Scientific American.
