Surgeons perform nation's first penile transplant

Massachusetts General Hospital announced that its team of surgeons performed the nation’s first genitourinary reconstructive (penile) transplant earlier this month.

The 15-hour procedure, led by Curtis L. Cetrulo Jr., MD, and Dicken S.C. Ko, MD, involved “surgically grafting the complex microscopic vascular and neural structures of a donor organ onto the comparable structures of the recipient,” according to a press release.

The patient is Thomas Manning, aged 64 years, of Halifax, Massachusetts, who had undergone a curative partial penectomy, or amputation of the penis, in 2012 when he was diagnosed with penile cancer. Manning is continuing to recover well, with blood flow established to the donor organ, and no evidence of bleeding, infection or rejection, according to the release. Physicians are “cautiously optimistic” he will regain function that he lost with the partial amputation.

“Today, I begin a new chapter filled with personal hope for others who have suffered genital injuries, particularly for our service members who put their lives on the line and suffer serious damage as a result,” Manning wrote in a statement. “In sharing this success with all of you, it’s my hope we can usher in a bright future for this type of transplantation.”

The genitourinary vascularized composite allograft (GUVCA) transplant was the culmination of more than 3 years of research and collaboration at Massachusetts General Hospital (MGH) across the plastic and reconstructive surgery, urology, psychiatry, infectious disease, nursing and social work departments, which are part of the MGH Transplant Center.

After the first hand transplant by an MGH team led by Cetrulo in 2012, he and Ko began researching the possibility of performing a GUVCA transplant, according to the release. The surgeons worked closely with the New England Organ Bank.

GUVCA transplants have three major goals: to reconstruct external genitalia to a more natural appearance, re-establish urinary function and potentially achieve sexual function, according to the release.
“We are hopeful that these reconstructive techniques will allow us to alleviate the suffering and despair of those who have experienced devastating genitourinary injuries and are often so despondent that they consider taking their own lives,” Cetrulo, of the MGH Division of Plastic and Reconstructive Surgery and the Transplant Center, stated in the release. “The entire transplant team has worked tirelessly to ensure that our patient is on the path to recovery, thanks in part to the gift of organ donation.”

“These proof-of-principle cases will help establish the techniques used in this procedure and will forge the path to future treatment of patients with significant pelvic and genitourinary tissue loss related to cancer, trauma or infection,” Ko, who directs the MGH Urology Regional Program, stated in the release.

Reference: www.massgeneral.org