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First-in-Human Bladder Transplant to Revolutionize Treatment of Terminally Compromised Bladders

By HospiMedica International staff writers
Posted on 02 May 2023
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Image: Urologists are set to perform the world’s first bladder transplant (Photo courtesy of USC Urology)
Image: Urologists are set to perform the world’s first bladder transplant (Photo courtesy of USC Urology)

Across the globe, hundreds of millions of people suffer from various degrees of bladder disease and dysfunction. Some of these patients may need a bladder reconstruction, a surgical procedure that involves removing the bladder and creating a new one from the patient's intestines. However, this surgery carries a high risk of early and delayed adverse side effects, and not every patient is eligible for the procedure. A team of urologists has now initiated a clinical trial to conduct the world's first human bladder transplant. The trial is actively screening potential participants for this groundbreaking transplantation. During the operation, the patient's diseased bladder will be removed and replaced with a healthy bladder from a deceased donor.

Bladder transplants have not been performed previously, partly due to the complex vascular structure of the pelvic area and the technical complexity of the procedure. For the past few years, surgeons at Keck Medicine of USC (Los Angeles, CA, USA) have been devising and practicing numerous research procedures in preparation for the first-of-its-kind bladder transplant, which will be conducted entirely using robotic surgery. This advanced form of minimally invasive surgery allows surgeons to employ a high-definition, three-dimensional camera to direct a robot in performing surgery through smaller, more accurate incisions with greater dexterity than possible with hand-held surgical instruments.

During the research and development phase, the surgeons successfully completed numerous practice transplantation surgeries, including the first-ever robotic bladder retrievals and successful robotic transplantations in five recently deceased donors whose cardiac function was maintained on ventilator support. The procurement, surgery, and post-surgical monitoring during transplantation adhered to current clinical and research standards.

“Transplantation is a lifesaving treatment option for conditions affecting many major organs, and transplanting a bladder could be a historic step in improving lives,” said Inderbir Gill, MD, founding executive director for USC Urology, part of Keck Medicine, who is also the principal investigator of the clinical trial and leading the transplantation efforts. “We could be on the verge of a medical advance that has the potential to revolutionize how we treat terminally compromised bladders.”

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