Oscar Larrainzar is the world's first bladder cancer patient who has received a replacement bladder. This ground-breaking surgery was conducted by a pair of surgeons, Dr Inderbir Gill and Dr Nina Nassiri from Southern California, USA, in March this year.
Bladder transplant surgery has considerable challenges because of the complex vascular infrastructure that is involved. The surgeons faced the challenge of needing to capture and preserve a rich supply of blood vessels, joining both left and right arteries and veins, which entailed a lengthy and technically precise operation.
In Mr Larrainzar's case, this took eight hours (and included a new kidney). Comparatively, bladder removal where the bladder is cut out and replaced by an ileal conduit (bag outside the body) may take as little as an hour. Bladder removal and replacement with a neobladder (pouch inside the body typically created from the small intestine) takes somewhat longer. As experienced by many, these procedures can have ongoing complications.
Bladder transplants are also not without their own complications. In particular, the body may reject the organ. The patient may also experience adverse side effects from the mandatory immune-suppressing drugs which are given to prevent organ rejection. However, so far so good with Mr Larrainzar!
Doctors Gill and Nassiri soon intend to perform four more bladder transplants as part of a clinical trial to become more informed on bladder capacity and graft complications before pursuing a larger clinical trial. This medical breakthrough is welcome news for the next generation of bladder cancer patients.
(Adapted from The New York Times, 18/05/2025)
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