PREVIEW

Surgeons have completed the world’s first human bladder transplant, calling it a “historic” operation with the potential to transform millions of lives affected by bladder disease.

The recipient, Oscar Larrainzar, had lived without kidneys and with a barely functional bladder for seven years, relying on dialysis to survive. Following the transplant, he no longer requires dialysis.

“My hope is to have a better life,” Mr Larrainzar said. “I'm still 42 and I have kids, I would like to see them grow so as much as I can have a better life, normal life, in the best possible way, that’s what I’m hoping for.”

The surgery, performed on May 4 through a collaboration between Keck Medicine of USC and UCLA Health, marks a major step forward in organ transplantation. According to the medical team, the patient is recovering well.

Dr Inderbir Gill, founding executive director of USC Urology, described the moment as transformative: “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.”

Dr Gill and UCLA urologic transplant surgeon Dr Nima Nassiri spent years refining the intricate surgical process. The procedure combined a kidney transplant followed by a bladder transplant, completed in an eight-hour operation.

“This first attempt at bladder transplantation has been over four years in the making,” Dr Nassiri said. “For the appropriately selected patient, it is exciting to be able to offer a new potential option.”

Mr Larrainzar had previously undergone bladder removal due to a tumour, and both kidneys were taken out because of renal cancer. But after surgery, Dr Nassiri confirmed that the new kidney began producing urine right away.

“There was no need for any dialysis after surgery, and the urine drained properly into the new bladder,” he said.

Despite the complexity of the transplant, Dr Gill said it proceeded smoothly: “The patient is doing well, and we are satisfied with his clinical progress to date.”

Millions globally suffer from bladder dysfunction. For patients with severely damaged bladders, the standard treatment often involves constructing a new bladder from intestinal tissue — a method that carries significant risks.

Dr Nassiri explained: “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.”

While this first surgery marks a significant breakthrough, the doctors acknowledged that there is still much to learn.

“Despite the unknowns, our goal is to understand if bladder transplantation can help patients with severely compromised bladders lead healthier lives,” Dr Gill said.

The procedure was carried out as part of a UCLA clinical trial, and the team hopes to perform more bladder transplants in the near future.