Washington: A team of surgeons at Massachusetts General Hospital (MGH) have performed the nation’s first genitourinary reconstructive (penile) transplant.
The 15-hour operation, which took place earlier this month, involved surgically grafting the complex microscopic vascular and neural structures of a donor organ onto the comparable structures of the recipient.
The patient, Thomas Manning, aged 64, continues to recover well, with blood flow established to the donor organ and no signs of bleeding, rejection or infection.
While the patient is still early in the post-surgical healing process, his physicians say they are cautiously optimistic he will regain function that he lost in 2012 when a diagnosis of penile cancer led him to undergo a curative partial penectomy – or amputation of the penis.
Called a genitourinary vascularized composite allograft (GUVCA) transplant, this month’s landmark procedure represents the culmination of more than 3Â½ years of research and collaboration across multiple departments and divisions within the MGH – including Plastic and Reconstructive Surgery, Urology, Psychiatry, Infectious Disease, Nursing, and Social Work – all of which are part of the MGH Transplant Center. Cetrulo and Ko together began researching the possibility of performing a GUVCA transplant in 2012, shortly after an MGH team led by Cetrulo completed its first hand transplant.
Working closely with the New England Organ Bank, both surgeons developed key strategic surgical approaches aimed at helping patients with devastating genitourinary injuries.
According to the surgeons, the three major goals of GUVCA transplants are to reconstruct external genitalia to a more natural appearance, re-establish urinary function, and potentially achieve sexual function.
The loss of genitalia can be truly devastating to an individual’s identity and sense of manhood. While individuals who have lost their penises to disease or who have suffered genitourinary injuries in combat or through a traumatic event can live without an intact organ, the psychological aspects of such an injury can be overwhelming, the surgeons said. The ability to offer a more acceptable long-term solution has been the motivation driving this research.
In a statement, the patient expressed his desire to tell his story to help others who may benefit from this type of procedure. “Today I begin a new chapter filled with personal hope and 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 sharing this success with all of you, it’s my hope we can usher in a bright future for this type of transplantation.”
Manning thanked his family and his medical team, and he extended his sympathies and gratitude to the generous family of the donor who gave him the chance for an improved quality of life.