Surgeons from Keck Medicine of USC and UCLA Health have completed the world’s first combined kidney and bladder transplant at Ronald Reagan UCLA Medical Centre.
It was a collaborative effort between USC Urology founding executive director Inderbir Gill, and UCLA Vascularised Composite Bladder Transplant programme director Nima Nassiri.
The patient, who has been on dialysis for seven years, has had both kidneys removed due to renal cancer, and lost most of his bladder during cancer surgery over five years ago.
The combined kidney and bladder transplant by Drs Gill and Nassiri allowed the patient to cease dialysis and produce urine for the first time in seven years.
Gill said: “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.
“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.”
Nassiri said: “This first attempt at bladder transplantation has been over four years in the making. For the appropriately selected patient, it is exciting to be able to offer a new potential option.
“The kidney immediately made a large volume of urine, and the patient’s kidney function improved immediately. There was no need for any dialysis after surgery, and the urine drained properly into the new bladder.”
Preparation for the transplant involved numerous pre-clinical procedures at Keck Medical Centre of USC and OneLegacy, Southern California’s organ procurement organisation.
The entire procedure, including the recovery of the kidney and bladder from the donor, adhered to the highest clinical and research standards.
Bladder transplants have been challenging due to the complex vascular structure of the pelvic area.
However, Drs Gill and Nassiri completed several practice surgeries, including robotic bladder retrievals and transplantations, to perfect the technique.
The transplant was part of a UCLA clinical trial, and the new transplant technique could provide an advanced alternative, regardless of organ rejection and drug side effects risks.
Gill added: “Despite the complexity of the case, 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.”
“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. “Despite the unknowns, our goal is to understand if bladder transplantation can help patients with severely compromised bladders lead healthier lives.”
