Southern California surgeons in the United States performed the first transplant of a human bladder, providing a new procedure that could change the lives of thousands of patients.
The operation was conducted on May 4 by surgeons from the University of California, Los Angeles, and the University of Southern California, for 41 -year -old Oscar Larsar, who lost a large part of his bladder due to treatments for a rare type of bladder cancer, according to the American New York Times.
Doctors plan to perform bladder transplants for 4 other patients as part of an experiment to find out the results of agriculture such as the capacity of the bladder and complications of the transplant before trying a large number of patients and expanding the scope of their use.
Dr. Anderber Jill, who performed surgery with Dr. Nima Nasseri, described the matter as a “dream” to treat thousands of patients suffering from exhausted pelvic pain, infections and repeated infection.
“There is no doubt that Baba was opened to these people had not been present before,” said Dr. Jill, head of the urology department at the University of Southern California.
Searching for a patient
Part of the intestine of most patients who undergo a bladder eradicate to help them urinate. Some get an intestinal canal, emptying urine in a bag outside the abdomen, while others are given the so -called new bladder, or a hidden cyst inside the body that is connected to the urethra and allows patients to urinate in a traditional way.
But the intestinal tissues are full of bacteria, and are polluted by their nature, as Dr. Jill said, and its introduction to the sterile urinary tract by nature leads to complications in up to 80% of patients, ranging from an imbalance of the electrolyte (such as sodium and potassium) to a slow decrease in kidney function. The loss of the intestinal part can also cause digestive problems.
In late 2020, Dr. Nasseri was in his fourth year of residency at the University of Southern California when he and Dr. Jill met to start discussing solutions. After Dr. Nasseri began a fellowship of kidney transplant at the University of California, Los Angeles, the two surgeons continued to work together in various institutions to test both robotic and manual techniques, where they practiced work first on pigs, then on human bodies, and finally on human donors in medical research that lost their brain activity but maintained their heartbeat.
One of the challenges of cultivation of bladder was the presence of blood vessels complex in this area of the body. Surgeons had to have a deep surgery inside the donor basin to capture and preserve the blood vessels so that the organ grows inside the recipient’s body.
“When we remove a bladder due to cancer, we simply cut it. We do this in about an hour. For donation of the bladder, this requires a much greater technical effort,” Dr. Jill said.
When their strategy was mastered in 2023, the two put plans to experience patients, which eventually resulted in the first recipient in the world: Oscar.
The ideal patient
Mr. Larinzar, a father of 4 children, was suffering from kidney disease in his last stage and kidney cancer, and Dr. Nasseri helped him eradicate his kidneys.
But Mr. Larinzar also survived from the urinary urinary canal (uraagal adenocarcinoma), a rare type of bladder cancer, and was left by a bladder tumor removal surgery without a bladder, said Dr. Nasseri. Natural bladder can accommodate more than 300 cm cubic per cent, while Mr. Larinzar can accommodate 30 centimeters cubic centimeters.
After years of dialysis, the condition deteriorated; Where the fluids accumulated inside his body. With the large number of scars in the abdominal area, it was difficult to find a long intestine suitable for use to follow another option.
“He appeared by chance, but he was an ideal candidate for this process,” said Dr. Nasseri.
One night this month, Dr. Nasseri received a phone call about the possibility of Mr. Larring’s bladder. He and Dr. Jill went directly to the ONELEGASI headquarters, a organ transplant organization, in Azusa, California, and joined a team of 7 surgeons who were working all night to eradicate a group of members from a donor.
The two college and bladder brought to the University of California, Los Angeles, and a little bit before the operation. And completing the 8 -hour surgery to plant a new bladder and a new college for Mr. Larsar later that day.
When the miracle occurs
Dr. Nasseri said that when the college and the bladder were connected within Mr. Larsar, there was a great contact -immediate production of urine -and the level of creatinine, which measures kidney function, began to improve immediately.
The transplantation of the new bladder does not include nervous communications in the recipient, so although it performs the storage function well, doctors did not know whether Mr. Larsar will one day be able to feel full of bladder, as well as his ability to naturally control and empty urine retention. They have talked about the use of abdominal movements, or even about a stimulus development of the bladder that works upon request to help the output process.
But at the date of follow -up on Thursday morning – just two days after Mr. Linzar left the hospital – Dr. Nasseri removed the urinary cemetery and gave him solutions, and Mr. Loarzar immediately felt that he could urinate.
Dr. Jill warned, “Of course, this is very early, to see how things will go. But it is the first time that he has been able to urinate seven years ago. For all of us, this is a great achievement.”