Surgeons Complete World’s First Human Bladder Transplant

In a watershed moment for organ transplantation, surgeons from USC and UCLA have successfully performed the world’s first-ever human bladder transplant.

The groundbreaking procedure, conducted at Ronald Reagan UCLA Medical Center on May 4, 2025, marks a new frontier in treating patients with non-functioning bladders who previously had limited options. The eight-hour operation involved transplanting both a kidney and bladder into a patient who had been on dialysis for seven years after losing most of his bladder to cancer.

The milestone surgery represents the culmination of four years of meticulous research and preparation by the surgical team led by Dr. Inderbir Gill of USC Urology and Dr. Nima Nassiri, a urologic transplant surgeon at UCLA Health. Their collaboration opens the door to potentially life-changing treatment for millions of people worldwide who suffer from severe bladder dysfunction.

What might this advancement mean for patients living with the daily challenges of a non-functioning bladder? For many, the answer could be a dramatic improvement in quality of life and freedom from the complications of current treatments.

Addressing a “Terminal” Condition

“This surgery is a historic moment in medicine and stands to impact how we manage carefully selected patients with highly symptomatic ‘terminal’ bladders that are no longer functioning,” said Dr. Gill, who is also Chair and Distinguished Professor of Urology and Shirley and Donald Skinner Chair in Urologic Cancer Surgery with the Keck School of Medicine of USC. “Transplantation is a lifesaving and life-enhancing treatment option for many conditions affecting major organs, and now the bladder can be added to the list.”

The patient who received the transplant had lost the majority of his bladder during cancer surgery over five years ago. The remaining portion was too small and compromised to function properly. Both of his kidneys were subsequently removed due to renal cancer, leaving him dependent on dialysis for seven years.

In the combined kidney and bladder transplant, surgeons first transplanted the kidney, followed by the bladder, and then connected the new kidney to the new bladder. The results were immediate and striking.

“The kidney immediately made a large volume of urine, and the patient’s kidney function improved immediately,” Dr. Nassiri noted. “There was no need for any dialysis after surgery, and the urine drained properly into the new bladder.”

Advantages Over Current Treatments

• Provides a more natural urinary reservoir compared to current procedures that use intestinal tissue
• May eliminate recurring infections associated with traditional bladder replacement techniques
• Could prevent digestive issues that often accompany intestine-based surgeries
• Potentially preserves kidney function better than existing approaches
• Allows patients to produce and store urine more normally

Years of Research and Preparation

The path to this medical milestone began years ago and involved extensive preparation. Dr. Nassiri, formerly a urology resident at USC and now assistant professor of urology and kidney transplantation at UCLA, worked alongside Dr. Gill to develop the surgical technique, design a clinical trial, and secure regulatory approvals.

“This first attempt at bladder transplantation has been over four years in the making,” Dr. Nassiri explained. “For the appropriately selected patient, it is exciting to be able to offer a new potential option.”

Before attempting the procedure on a human patient, the team completed numerous practice surgeries at Keck Medical Center of USC. These included the first-ever robotic bladder retrievals and successful robotic transplantations in recently deceased donors with cardiac function maintained on ventilator support.

Additional non-robotic trial runs of bladder recovery were performed at OneLegacy, Southern California’s organ procurement organization, allowing the surgeons to perfect their technique while working with multidisciplinary surgical teams.

A New Hope for Millions with Bladder Dysfunction

Bladder dysfunction affects millions globally, with some patients developing “terminal bladders” that cause constant pain, recurring infections, and other serious complications. Current treatments for severe cases typically involve creating a new bladder using portions of the patient’s intestine, or constructing an alternative pathway for urine to exit the body.

“While these surgeries can be effective, they come with many short-and long-term risks that compromise a patient’s health such as recurrent infections, compromised kidney function and digestive issues,” said Dr. Gill.

“A bladder transplant, on the other hand, delivers a more ‘normal’ urinary reservoir and may circumvent some of the challenges associated with using the intestine,” added Dr. Nassiri.

Challenges and Future Directions

As with all organ transplants, rejection and the side effects of immunosuppressive medications remain significant concerns. The team notes that currently, the best candidates for bladder transplantation would be patients who already have another organ transplant or those who need a combined kidney and bladder transplant, as they would already require immunosuppression.

Many questions still remain about how well a transplanted bladder will function over time and what level of immunosuppression will ultimately be necessary. Yet despite these unknowns, the surgical team remains optimistic about the procedure’s potential.

“Despite the unknowns, our goal is to understand if bladder transplantation can help patients with severely compromised bladders lead healthier lives,” said Dr. Gill.

The bladder transplant was performed as part of a UCLA clinical trial, with both surgeons hoping to collaborate on more bladder transplants in the near future. This historic achievement builds on USC Urology’s reputation as a pioneer in advanced robotic urologic surgeries and UCLA Health’s excellence in transplantation medicine. For millions suffering from severe bladder dysfunction, this surgical first represents not just a technical achievement, but a new pathway to potentially reclaim their health and quality of life.