Doctors perform first U.S. penis transplant

Doctors at Massachusetts General
Hospital performed the first U.S. penis transplant,
they said Monday, calling it a "landmark
procedure."
Thomas Manning, 64, is recovering well after the
15-hour procedure performed by a team of over
50 surgeons, doctors and nurses, this month,
according to the hospital. Manning, of Halifax,
Massachusetts, had his penis amputated after he
was diagnosed with penile cancer in 2012.
The procedure, also described by the doctors as a
"surgical milestone," is called a gentitourinary
vascularized composite allograft, or GUVCA.
It involves "surgically grafting the complex
microscopic vascular and neural structures of a
donor organ onto the comparable structures of the
recipient."
Put another way, "surgeons connected the
intricate vascular and nerve structures of a donor
penis with those of the 64-year-old transplant
recipient," the hospital said.
Dr. Dicken Ko, director of the hospital's Regional
Urology Program, said the objectives of the
surgery were primarily to reconstruct the genitalia
so that it appeared natural, followed by urinary
function and hopefully sexual function. However,
Ko added that while sexual function is a goal,
reproduction is not, because of a concern
surrounding the ethical issues of who the potential
father may be.
Although Manning is still healing from the
surgery, his doctors said there are no signs of
bleeding, rejection or infection, and they are
cautiously optimistic that he will regain function.
They expect him to leave the hospital in the next
three or four days.
"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 said in a
statement provided by the hospital. He also
expressed gratitude to his family and his medical
team, as well as to the family of the donor.
"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 they consider taking their own lives,"
said Dr. Curtis L. Cetrulo, a plastic and
reconstructive surgeon who led the transplant
team along with Ko.
They worked with doctors in infectious disease,
psychiatry and social work and with the New
England Organ Bank to identify a suitable donor.
Cetrulo said the surgery was an effort 3½ years in
the making, building on their previous work.
"It's on a continuum of transplants ... hand, face,
abdominal wall. ... We felt comfortable because of
our experience with hand transplants," he said.
Manning will need to take immunosupressing
drugs for the rest of his life to diminish any
chance of rejection. Certulo added that the
immunosupressants may in fact "help the nerves
regrow," hopefully contributing to his success.
Certulo and Ko said they hope that this procedure
can help put them on a path to help wounded
servicemen. "There's a real patient-driven need,"
Certulo said.
Eventually, they hope this may even be used with
gender reconstruction surgery.
However, Certulo also pointed out that there was
still a lot to learn about this process and how it
would fit for each patient. "Every case is different.
We really had to tailor our procedure to our
patient."