Surgeons in the US have performed a ‘miracle’ bladder transplant for the first time — giving hope to thousands of patients living with deadly organ failure.
The first ever patient to undergo the groundbreaking operation is Oscar Larrainzar, a 41 year-old from Los Angeles with a rare form of cancer who lost nearly all function of his bladder.
Now, following the successful procedure, he is not only able to use the toilet independently again, but doctors said the surgery also saved his life.
Doctors have hailed the procedure a ‘groundbreaking moment in medical history’ and ‘the realisation of a dream’.
Dr Inderbir Gill, the urologist who performed the transplant, said: ‘There is no question: A potential door has been opened for these people that did not exist earlier.
‘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,’ he told the New York Times.
Following treatment for tracheal adenocarcinoma, a rare type of bladder cancer, and a surgery to remove the tumour four years ago, Mr Larrainzar had ‘been left without much of a bladder at all.’
A normal bladder can hold more than 300 cubic centimeters of fluid. But Mr Larrainzar’s could hold 30, according to his medical team.
Patient Oscar Larrainzar had a rare form of cancer and following treatment and had lost nearly all function of his bladder – describing himself as a ‘ticking time bomb’
In a procedure that took eight hours Mr Larrainzar had a kidney and bladder transplant
The world first surgery was performed by Dr Nassiri (left) and a team of doctors at University College Los Angeles Medical Centre
The patient had also been dialysis-dependent for seven years after both of his kidneys were subsequently removed as part of his cancer treatment.
To address these deficits doctors performed a combined kidney and bladder transplant, allowing the patient to immediately stop dialysis and produce urine for the first time in seven years.
First the kidney, then the bladder, were transplanted. The new kidney was then connected to the new bladder. The entire procedure took approximately eight hours.
‘The kidney immediately made a large volume of urine, and the patient’s kidney function improved immediately,’ Dr Nassiri, who was part of the team of surgeons who performed the procedure, added. ‘There was no need for any dialysis after surgery, and the urine drained properly into the new bladder.’
‘Despite the complexity of the case, everything went according to plan and the surgery was successful,’ said Dr Gill, who is chairman of the urology department at University of Southern California.
‘The patient is doing well, and we are satisfied with his clinical progress to date.’
‘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.’
Doctors have heralded the procedure a ‘groundbreaking moment in medical history’
Typically, rather than a transplant, patients with a failing bladder are fitted with what’s known as a neobladder—a bag that collects the urine outside the body.
Some patients will have their intestine repurposed by surgeons to enable the organ to pass urine.
Experts say that patients suffer complications up to 80 per cent of the time when the intestine is used to replace the bladder, which Mr Larrainzar had been living with for four years.
They say it can lead to digestive issues, kidney failure and cause deadly bacteria to spread in 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 recurrent infections, compromised kidney function and digestive issues,’ said Dr Gill.
‘A bladder transplant, on the other hand, delivers a more ‘normal’ urinary reservoir and may circumvent some of the challenges associated with using the intestine,’ said Dr Nassiri.
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 before pursuing a larger trial to expand its use.
The biggest risks of organ transplant are the body’s potential rejection of the organ and side-effects caused by the immunosuppressive drugs given to prevent organ rejection.
Dr Gill added that the best current candidates are those who’ve coped with an organ transplant previously, or those who need a combined kidney and bladder transplant.
