Keck Medicine prepares to perform the world’s first-ever bladder transplant

Over the years, heart, lung, liver and kidney transplants have become commonplace at top medical centers like ours. Transplantation is a lifesaving treatment option for many, and our USC Transplant Institute has helped pioneer the field.

Some organ transplants have remained out of reach of the medical profession, however, such as bladder transplants. But that might be about to change.

Keck Medicine of USC urologists, led by Dr. Inderbir Gill, working in conjunction with the USC Transplant Institute, have launched a clinical trial to perform the world’s first human bladder transplant, and are actively screening potential participants. Gill is the founding executive director for USC Urology and Chairman and Distinguished Professor, Catherine and Joseph Aresty Department of Urology at the Keck School of Medicine of USC.

During the procedure, the patient’s diseased bladder will be removed and replaced with a healthy bladder from a deceased organ donor, potentially putting Keck Medicine on the forefront of a medical advance that could dramatically improve lives.

Many people around the globe experience varying degrees of bladder disease and dysfunction that can cause severe discomfort, pain and distress. Currently, the only treatment for a terminal, unusable bladder is bladder reconstruction, where the bladder is removed and replaced with a new bladder made from the patient’s intestines.

However, bladder reconstruction carries a risk of early and delayed adverse side effects, and not every patient is a candidate for this surgery.

Enter the revolutionary option of a bladder transplant, which Gill and his colleagues, including his collaborator on the clinical trial, Dr. Nima Nassiri, have been researching and developing for the last two years. As part of their research, they completed many practice transplantation surgeries, including bladder retrievals and successful transplantations in five recently deceased donors with cardiac function maintained on ventilator support.

Bladder transplantation has never been done before, in part because of the complicated vascular structure of the pelvic area that makes surgery in this area of the body extremely difficult.

Gill and his colleagues, however, found the key to making the complex procedure viable: robotic surgery, which uses a high-definition, three-dimensional camera to guide a robot to perform surgery with more dexterity than is possible using hand-held surgical tools.

Under Gill’s direction, USC Urology has already been far ahead in the robotics game, having previously developed robotic and minimally invasive techniques for kidney, bladder and prostate cancer. This expertise, combined with USC Transplant Institute’s skill and resources, has brought us to this new horizon.

Keck Medicine is dedicated to innovative medicine to improve patient outcomes. The first-ever bladder transplant for a subset of patients with debilitating, terminal bladder disease is an exciting example of how our physicians and researchers continually push medicine forward to make the impossible possible.

I wish Dr. Gill the best as his team embarks on this clinical trial. I am also thankful for the organ procurement organization OneLegacy Foundation, which provided clinical trial funding and, with the generous agreement of donor families, enabled the bladder donations in the research phase.

Stay tuned to potential history in the making. I know I certainly will be.?