The surgery was performed on 41-year-old Oscar Larrainzar, who had lost most of his bladder due to treatment for a rare form of cancer
Doctors in California have successfully performed the world's first human bladder transplant, offering new hope to those who have serious bladder problems. The surgery is said to be a “game-changer," a new method for victims of bladder dysfunction.
Done earlier this month by two doctors from the University of California, Los Angeles (UCLA), and the University of Southern California (USC), it was performed on 41-year-old Oscar Larrainzar, who had lost most of his bladder due to treatment for a rare form of bladder cancer.
“I was a ticking time bomb,” Larrainzar told the New York Times. “But now I have hope.” Larrainzar's both kidneys had been removed due to cancer and end-stage kidney disease, and he was on medical dialysis for seven years.
Doctors say they now plan to do four more bladder transplants as part of a small trial. They want to understand possible risks, including how well the bladder works and if the body rejects the new organ. “(The surgery is) the realisation of a dream,” said Dr. Inderbir Gill from USC, adding that it could help people with long-term bladder problems like pain, infections, and inflammation.
What happens when you lose your bladder?
Usually, patients who lose their bladder have part of their intestine repurposed, providing a new way to urinate. But that method has severe side effects - bowel tissue contains bacteria and is not sterile, which causes a lot of health issues in more than 80 per cent of patients. Doctors say it also leads to a lot of digestive issues.
This new transplant surgery was developed slowly over many years, with the doctors first practicing on pigs and then testing the method on donated human organs. However, a big challenge was carefully removing the bladder with its blood vessels so it could be safely transplanted.
According to experts, early diagnosis and treatment of bladder cancer are important for survival from the disease, which was expected to include more than 82,000 new US cases in 2023 and roughly 16,700 deaths, according to the American Cancer Society. Research released late last year found that an experimental new drug spurred a complete remission of bladder cancer in three-quarters of patients who had not responded to an immune-focused treatment typically used to fight the disease.
How was the surgery conducted?
To make the surgery safer, the doctors said they connected the bladder’s main blood arteries while the organ was on ice. That way, they only had to attach two arteries instead of four when placing it in the patient. The transplant team got their first match in early May. They picked up the donor bladder and a kidney from an organ center, then completed an eight-hour surgery at UCLA.
Larrainzar needed both organs because he had kidney failure and severe bladder damage. The results were promising as the new kidney started working right away, and Larrainzar began losing excess fluid.
His creatinine level, a key sign of kidney function, improved fast. Even more surprisingly, just two days after going home, he felt he was able to urinate on his own.
Why are the doctors cautious?
According to experts, this kind of transplant may not be right for everyone. Those who get transplants have to take drugs for life to stop their body from rejecting the new organ, which has a lot of side effects.
Doctors also are not sure if Larrainzar would be able to feel when his bladder was full or empty it normally does. At first, they planned to use catheters or special devices to help him.
