Introduction to a Medical Breakthrough
A California cancer survivor was the recipient of the world’s first in-human bladder transplant this month, thanks to a pair of Los Angeles doctors.
Surgeons from Keck Medicine of USC and UCLA Health teamed up to perform the 8-hour operation at Ronald Reagan UCLA Medical Center on May 4.
The Surgical Team and Their Mission
The two surgeons – Inderbir Gill, MD, founding executive director of USC Urology and Nima Nassiri, assistant clinical professor of urology at UCLA – began to seriously consider the operation more than four years ago.
“This is something that’s been built over a lot of nights of sweat, blood and tears,” said Nassiri.
The doctors said they were determined to discover a technique to perform a bladder transplant for those with debilitating, non-functioning bladder conditions, who have exhausted all resources and need, or will need, immunosuppression.
Preparation and the Clinical Trial
Gill and Nassiri designed a clinical trial, secured regulatory approvals, and performed numerous pre-clinical procedures at Keck Medical Center of USC and OneLegacy, Southern California’s organ procurement organization, before attempting the first-in-human bladder transplant.
Oscar Larrainzar, 41, of West Covina, was deemed an ideal candidate. He’s a bladder cancer and kidney cancer survivor, who previously had his kidneys and part of his bladder removed. Larrainzar was on dialysis for seven years.
The Patient’s Story and Motivation
“I still have a lot to live [for],” said Larrainzar.
He’s a husband and father of four, with kids between the ages of 9 and 19. He said his family is what motivated him to participate in the groundbreaking surgery.
“The fact that I have a family, the fact that I still want to live, the fact that I want to help my family," he said. "I want to see my little girl grow. My other ones fulfill. My wife, she’s my hero right now, because she’s there for me every day.”
Post-Surgery Progress and Future Plans
Larrainzar is three weeks out from receiving a new bladder and a new kidney. He said he’s doing well, despite dealing with pain.
“So far, Oscar has actually demonstrated quite amazing results," Nassiri said. "He’s voiding spontaneously, which is fantastic. So, already the results are good, fantastic frankly, but we want to be cautiously optimistic.”
The team will continue to monitor Larrainzar’s progress and hopes to perform more bladder transplants soon. The UCLA clinical trial lasts two years, with approval for five patients.
The Significance and Potential of Bladder Transplantation
The doctors said that for those who qualify, the transplant surgery is a good alternative to treatment being used now.
“The current gold standard for patients is creating a urinary reservoir using intestine and that works fine and has been available for decades, but for patients who are going to be on immunosuppression, that predisposes them to a lot of complications potentially down the road, short and long term," Nassiri said.
"So, if you have a more natural reservoir, for people on immunosuppression because of kidney transplant for instance," he continued, "it makes a lot more sense to have a bladder which has normal function for storing urine as opposed to bowel or intestine which absorbs naturally, so to try to circumvent some of these complications we wanted to develop this technique.”
Conclusion
Larrainzar said he’s grateful to have participated and hopes his experience can help others as the UCLA clinical trial continues.
“If it’s a success, what they did to me, then it brings a lot of hope to others,” said Larrainzar. “Every day, every single day, I’m thankful, just for another day.”
Gill and Nassiri also shared their gratitude and hope for the future of the operation.
"Having something new in medicine, especially surgery, is kind of rare nowadays," Nassiri said, "A lot of it has been done, so I’m honored and grateful to be able to contribute to urology as a field.”
“It’s all about innovation, improving the human condition," Gill said. "It’s such a privilege.”
FAQs
Q: What is the significance of the world’s first in-human bladder transplant?
A: The world’s first in-human bladder transplant signifies a major breakthrough in medical science, offering new hope to patients with debilitating bladder conditions.
Q: What motivated the patient, Oscar Larrainzar, to participate in the surgery?
A: Larrainzar’s motivation stemmed from his desire to live for his family and see his children grow, despite his health challenges.
Q: How long does the UCLA clinical trial last, and how many patients are approved for the trial?
A: The UCLA clinical trial lasts two years, with approval for five patients.
Q: What are the potential benefits of bladder transplantation compared to current treatments?
A: Bladder transplantation could offer a more natural reservoir for storing urine, potentially reducing complications associated with current treatments that use the intestine.
Q: What is the next step for the surgical team and the patient?
A: The team will continue to monitor Larrainzar’s progress and hopes to perform more bladder transplants soon, contributing to the advancement of urology and improving patient outcomes.
