Bladder transplant—surgeons in the operating room with spotlight on patient's torso Nick Carranza/UCLA Health
Oscar Larrainzar, a 41-year-old father of four, had a non-functioning bladder and had both kidneys removed due to renal cancer in the setting of pre-existing end-stage kidney disease. As a result, he was on dialysis for seven years.
The main risks of organ transplantation are the body’s immune system rejecting the new organ and the side effects of the immunosuppressive drugs required to prevent rejection.
Surgeons at UCLA Health have successfully performed the first-ever human bladder transplant, offering new hope for patients with bladder dysfunction and pain.
The surgery took place on May 4 at Ronald Reagan UCLA Medical Center. The team, led by Dr. Nima Nassiri and supported by Dr. Inderbir Gill, had spent years perfecting the technique.
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This milestone has been over four years in the making. For the right patient, it opens up a promising new treatment option.
The donor’s kidney and bladder were recovered at OneLegacy. Every step of the procedure, from surgery to post-operative care, followed the highest clinical and research standards.
Bladder transplants had never been performed before due to the complex blood vessels in the pelvic area and the technical challenges of the procedure. Existing treatments involve using part of the patient’s intestine to create a new bladder or an alternate urine pathway. While effective, these methods come with risks like internal bleeding, infections, and digestive complications.
Surgeons transplanted both a new kidney and bladder from a donor, first placing the kidney, then attaching it to the bladder using their newly developed technique. The procedure took about eight hours.
Bladder organoids to study UTIs in a more controlled way
The results were immediate— the kidney started producing urine right away, improving function instantly. The patient didn’t need dialysis after surgery, and the new bladder successfully drained urine.
There are still uncertainties surrounding the procedure, such as how well the transplanted bladder will function long-term and the exact level of immunosuppression needed to prevent rejection. So far, Larrainzar has remained stable.
The surgery was part of a UCLA clinical trial led by Nassiri and Gill, who aim to conduct more bladder transplants soon.
During the research phase, Nassiri and Gill conducted multiple practice transplant surgeries at Keck Medical Center of USC, including the first robotic bladder retrievals and successful robotic transplants in five donors on ventilator support.
They also performed non-robotic bladder recovery trials at OneLegacy, refining the technique with multidisciplinary teams.
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