Surgeon completes the world’s first human bladder transplant

At a watershed moment of organ transplantation, surgeons from UCLA and UCLA successfully performed the world’s first human bladder transplant.

The groundbreaking procedure was conducted on May 4, 2025 at Ronald Reagan UCLA Medical Center, marking a new boundary for the treatment of non-functional bladder patients who had previously had no limited choice. The eight-hour surgery involved transplanting the kidney and bladder to a patient who had been dialyzed for seven years after losing most of his bladder to develop cancer.

The milestone surgery represents the climax of four years of careful research and preparation for the surgical team led by USC Urology Inderbir Gill, PhD, and Urology surgeon at UCLA Health. Their collaboration opens up potential life-changing treatments for millions of people around the world who suffer from severe bladder dysfunction.

What does this advancement mean for patients who suffer from the daily challenge of non-functional bladder? For many, the answer may be a huge improvement in quality of life and freedom from current treatment complications.

Solve the “terminal” condition

“This surgery is a historic moment in medicine and affects how we manage patients with highly symptomatic ‘terminal’ bladder that no longer works,” Dr. Jill said. “The transplant is a life-saving and life-enhancing treatment option for many conditions that affect major organs, and bladder can now be added to the list.”

Patients who received the transplant lost most of their bladder during cancer surgery five years ago. The rest is too small to compromise to function properly. His two kidneys were subsequently removed due to kidney cancer, leaving him dependent on dialysis for seven years.

In a combined kidney and bladder transplant, the surgeon first transplants the kidney, then the bladder, and then connects the new kidney to the new bladder. The results are straightforward and amazing.

“The kidneys immediately reduce a lot of urine and the patient’s renal function improves immediately,” Dr. Nassiri noted. “No dialysis is required after the surgery, and urine is properly discharged into the new bladder.”

Better than current treatment

• Provides a more natural urine storage fluid than the current procedure using intestinal tissue
• Possibly eliminate recurring infections associated with traditional bladder replacement techniques
• Can prevent digestive problems that are usually accompanied by intestinal surgery
• Probably better preserve renal function than existing methods
• Allows patients to produce and store urine more normally

Years of research and preparation

The road to this medical milestone began several years ago and involved extensive preparation. Dr. Nassiri, formerly a Urology resident at UCLA and now an assistant professor of urology and kidney transplant at UCLA, has developed surgical techniques, designed clinical trials and safe regulatory approvals with Dr. Gill.

“It’s been over four years since the first attempt at a bladder transplant,” explains Dr. Nassiri. “For patients with appropriate choices, it’s exciting to be able to offer new potential options.”

The team completed many practice surgeries at Keck Medical Center in USC before attempting surgery on human patients. These include the first ever robotic bladder search and successful robot transplants in donors of recent dead people who maintained cardiac function in ventilator support.

Onelegacy, an organ procurement organization in Southern California, conducted additional non-bladder recovery trials, allowing surgeons to perfect their technology when working with a multidisciplinary surgical team.

New hope for millions of bladder dysfunction

Bladder dysfunction affects millions of people around the world, and some patients develop “end bladder”, resulting in persistent pain, repeated infections and other serious complications. Current treatment for severe cases often involves the use of a portion of the patient’s intestine or the creation of a new bladder for alternative pathways to exit the body of urine.

“While these surgeries may be effective, they have many short-term and long-term risks that harm the patient’s health, such as recurrent infections, renal function and digestive problems,” Dr. Jill said.

“On the other hand, bladder transplantation provides a more ‘normal reservoir of urine that may avoid some of the challenges associated with the use of the intestine,” Dr. Nassiri added.

Challenges and future directions

Like all organ transplants, rejection and side effects of immunosuppressive drugs remain an important concern. The team notes that at present, the best candidates for bladder transplants are patients who have already undergone another organ transplant or those who need kidney and bladder transplants because they already need immunosuppression.

There are still many questions about the effectiveness of the transplanted bladder functioning over time and ultimately necessary levels of immunosuppression. However, despite these unknowns, the surgical team remained optimistic about the potential of the procedure.

“Despite unknowns, our goal is to understand whether bladder transplants can help patients who seriously damage their bladder to live healthier lives,” Dr. Jill said.

The bladder transplant is conducted as part of a clinical trial of UCLA, and both surgeons hope to do more bladder transplants in the near future. This historical achievement is known for USC Urology’s outstanding performance in advanced robotic urology and UCLA Health in transplant medicine. For millions of people with severe bladder dysfunction, this surgery represents not only a technical achievement, but also a new pathway to potentially restore their health and quality of life.