First-Ever Human Bladder Transplant Performed in the U.S.

Historic Medical Breakthrough: Doctors Perform First Human Bladder Transplant in the U.S.

In a world-first surgical milestone, a team of doctors in the United States has successfully transplanted a human bladder into a patient. The groundbreaking operation was carried out on May 4 at the Keck School of Medicine of the University of Southern California, in collaboration with the University of California, and was only recently made public. The recipient, a 41-year-old man, had previously lost most of his bladder due to cancer and had been undergoing dialysis for seven years.

“This is a historic moment,” said Dr. Inderbir Gill, one of the lead surgeons involved in the operation. “Transplants save and improve lives for many people suffering from organ failure. Now we can add the bladder to the list of transplantable organs.”

Why the Bladder Was Considered Untransplantable

Until now, the bladder was thought to be too complex for transplantation. It is supplied by at least six small arteries and has multiple venous drainage vessels, making surgical reconnection highly difficult. Moreover, since the bladder is not a vital organ, subjecting patients to lifelong immunosuppression—required to prevent organ rejection—has generally been deemed unjustifiable.

Dr. Johannes Huber from the University Hospital in Heidelberg noted, “The risks of immunosuppression usually outweigh the benefits for non-life-saving organs. That’s why bladder transplants are likely to remain extremely rare.”

Why This Surgery Was Justified

In this unique case, the patient had not only lost his bladder due to cancer but also required a kidney transplant. Such a rare combination of medical needs allowed doctors to justify the high-risk procedure. All transplanted organs—the bladder and both kidneys—came from a single donor and were transplanted in an eight-hour operation.

“The kidney immediately began producing large amounts of urine, and the patient’s renal function improved right away,” said Dr. Nima Nassiri, another surgeon on the team. The man no longer needs dialysis—the first time in seven years he has lived without it.

Existing Alternatives to Bladder Transplantation

Currently, bladder function can be restored using part of the patient’s small intestine to form a neobladder, especially in cancer patients. However, these surgical substitutes often fail to fully mimic the functionality of a natural bladder. “A healthy bladder can contract and release urine based on neural commands,” explained Dr. Huber. “A neobladder made from intestinal tissue lacks that ability. Patients often have to manually apply abdominal pressure or use catheters to urinate.”

This often works better in men, while women may have a stronger urethral sphincter that complicates manual voiding.

Open Questions and Future Plans

Despite the apparent success, experts remain cautious. Professor Peter Albers from the University Hospital in Düsseldorf questioned whether the transplanted bladder would be capable of voluntary urination: “Good nerve supply is essential for bladder function, and that’s currently very difficult to achieve—even with a transplant.”

Nevertheless, the surgical team plans to perform the procedure on four additional patients and is preparing a clinical study to evaluate long-term outcomes. If successful, this innovation could mark a new era in reconstructive urology and transplantation medicine.