Tue | Sep 25, 2018

First penile transplant in the US

Published:Sunday | May 22, 2016 | 12:00 AM
Thomas Manning gives a thumbs up after being asked how he was feeling following the first penis transplant in the United States, in Boston. The organ was transplanted from a deceased donor.
Dr Dicken Ko, director of Massachusetts General Hospital’s urology programme, speaks during a news conference at the hospital last Monday, about cancer patient Thomas Manning of Halifax, Massachusetts, who received a transplanted penis in a 15-hour procedure last week.


Add one remarkable case to the 30,000-plus organ transplants expected to be performed in the United States (US) this year - a cancer patient who received a donor penis.

The 64-year-old cancer patient has received the nation's first penis transplant, a groundbreaking operation that may also help accident victims and some of the many US veterans maimed by roadside bombs.

In a case that represents the latest frontier in the growing field of reconstructive transplants, Thomas Manning of Halifax, Massachusetts, is faring well after the 15-hour operation last week, Massachusetts General Hospital said Monday.

His doctors said they are cautiously optimistic that Manning eventually will be able to urinate normally and function sexually again for the first time since aggressive penile cancer led to the amputation of the former bank courier's genitals in 2012. They said his psychological state will play a big role in his recovery.

Worldwide, there have been faces, tongues, hands, legs, uteruses - and now the third penis transplant, a first in the US. Could any body part be left to transplant? Research is ongoing for eyeballs, and an Italian doctor has raised eyebrows with talk of a brain transplant.

Still, the vast majority of operations involve more conventional organs.

Since the nation's first successful human organ transplant in 1954, involving a kidney, more than 700,000 organ transplants have been done nationwide. Kidneys are the most commonly transplanted organ - almost 18,000 US operations were done last year, followed by livers - about 7,000, and hearts - nearly 3,000, according to the United Network for Organ Sharing.

Some of the more rare transplants:




Since the world's first face transplant in France in 2005 on a woman mauled by family dog, about 30 more have been done. These include a 26-hour operation last August at NYU Langone Medical Center on a Mississippi firefighter whose face was charred in a fire. Other US cases include a Connecticut woman who got a new face after a 2009 attack by a friend's chimpanzee.




The first US uterus transplant failed shortly after the February 24 operation at the Cleveland Clinic, but others are planned. About 14 have been done worldwide, said Dr Vijay Gorantla, medical director of the University of Pittsburgh reconstructive transplant programme. These include a 2013 operation in Sweden resulting in the first reported live birth from a transplanted uterus.




Hand and/or arm transplants have been done in more than 85 people globally, according to Johns Hopkins Medicine, a leading transplant centre. Its patients include the first US soldier to survive losing all four limbs in the Iraq War, who had a double-arm transplant in 2013.

Gorantla said the first US patient, a New Jersey man injured in a firecracker accident, still has total use of his donor hand 17 years after an operation at Louisville's Jewish Hospital.




Only three total leg-foot operations have been done worldwide, Gorantla said, but the operations are still experimental. US centres researching the procedure include Brigham and Women's Hospital in Boston, where doctors say potential candidates could include amputees injured in the 2013 Boston Marathon bombings.




Tongues have been transplanted in total face transplants and in at least one case, alone in an Austrian patient with mouth cancer.

Gorantla and his team has a $1 million-plus military grant to establish the nation's first whole eyeball transplant programme, with injured veterans among the potential candidates. He calls this the "holy grail" in transplant medicine, but the operations would be tricky because they would require regenerating the optic nerve, which sends signals to the brain. Success in animal research suggests that the procedure will work in humans, he said.

A doctor in Italy has talked of attempting human head and brain transplants, but that raises complicated ethical issues, and many mainstream scientists are sceptical.