Why this transplant had never been attempted before
Despite the spectacular progress of the transplantation of organs, the human bladder remained so far out of the reach of the surgeons. Too complex, too vascularized … The reasons for this absence were multiple. But everything changed for Oscar Larrainzar, a 41 -year -old man, father of four children who had already lost most of his bladder during tumor ablation, leaving the rest too small. Also been removed later due to cancer and terminal renal failure, and he had been under dialysis for seven years.
Admitted to UCLA Health, Oscar was offered a Combined Rein-Vessie, a world premiere validated by the medical authorities. He was the ideal candidate for this intervention. His illness, associated with an absence of lasting solution by conventional treatments, justified the audacity of this attempt.
On March 10, 2024, the American teams of Keck Medicine of USC and UCLA Health have united their skills to carry out this historical intervention. The operation was carried out well after several months of meticulous preparation.
A surgical feat with major implications
Doctors Nima Nassiri and Inderbir Gill, assisted by a surgical team, first transplanted the kidney, then the bladder; They then connected the kidney to the new bladder. The intervention lasted about eight hours but the results were quickly visible. “”The kidney immediately produced a large volume of urine, and the patient’s kidney function immediately improved“Said Dr. Nassiri.”No dialysis was necessary after the operation, and the urine has properly drained in the new bladder“.
“”Despite the complexity of the case“said Dr. Gill,”Everything went as planned and the operation was a success. The patient is doing well and we are satisfied with his clinical evolution to date“.
So far, the reconstruction of the bladder in seriously affected patients was made from intestinal segments – an imperfect technique. “”Although these surgical interventions can be effective, they have many short and long -term risks that compromise patient health, such as recurring infections, compromised renal function and digestive problems“, Specifies Dr. Gill.
This first bladder transplant aims to offer a more physiological, better tolerated, and more sustainable alternative. The first tests show an excellent recovery without organ rejection, which confirms the immediate success of the operation.
A advance of hope for thousands of patients
Each year, thousands of people worldwide live with chronic bladder diseases, sometimes disabling. Between malformations, sequelae of infections or cancer treatments, solutions are sorely lacking for those whose organ no longer fulfills its role.
This pioneer transplant opens a new path. “”Despite the unknowns, our goal is to understand whether the transplantation of bladder can help patients suffering from a bladder seriously compromised to lead a healthier life “said Gill.
As a first attempt in humans, this procedure naturally includes many unknowns, in particular immediate operation and over time of the transplanted bladder, and the degree of immunosuppression which will ultimately be necessary. The medical team closely follows the evolution of Oscar Larrainzar. As part of this clinical trial, teachers Gill and Nassiri hope to carry out other bladder transplants in the near future. Objective: to make this transplant accessible to other patient profiles, and permanently transform the care of severe urological pathologies.