Cancer Patient Receives First Penile Transplant Performed in United States

Earlier this month a team of surgeons performed the first genitourinary reconstructive penile transplant in the United States on a patient who had a curative partial penectomy in 2012 due to a rare form of penile cancer.

The 15-hour operation, which included surgically grafting an organ from a deceased donor, took place at the Massachusetts General Hospital earlier this month. The surgery involved a team of 7 surgeons, 6 medical residents, and more than 30 other clinical professionals.

Lead surgeons Curtis L. Cetrulo, Jr, MD, and Dicken S. C. Ko, MD, and their team performed the still-experimental operation on Thomas Manning, a 64-year-old patient from Halifax, Massachusetts. Manning is recovering well so far, with blood flow to the organ and no rejection or infection, according to his clinical care team.

Manning is still using a catheter but the team stated that they are optimistic he will regain normal urination and sexual functions within weeks to months. Manning will likely need to be on immunosuppressant drugs for the rest of his life to prevent rejection of the grafted organ.

“These proof-of-principle cases will help establish the techniques used in this procedure and will forge the path to future treatment of patients with significant pelvic and genitourinary tissue loss related to cancer, trauma, or infection,” said Ko, a urologist and transplant surgeon who directs the Massachusetts General Hospital’s regional urology program. “We are delighted to have taken the first steps to help those patients who have suffered silently for far too long.”

Penile cancer is relatively rare. In the United States it is estimated that 2,030 new cases and 340 deaths will occur this year.

The surgery, called a genitourinary vascularized composite allograft (GUVCA) transplant, is the result of a collaboration among different divisions within the Massachusetts General Hospital’s transplant center-plastic and reconstructive surgery, urology, psychiatry, infectious disease, nursing, and social work. The team worked for 3 years to prepare and develop the surgical approach and partnered with the New England Organ Bank. A GUVCA involves connecting the microscopic blood vessels and nerves of the donor organ to those of the patient.

The first successful penile transplant in the world was performed in December 2014 in South Africa. That surgery required 9 hours on a younger patient whose penis had been amputated 3 years prior. The transplant was deemed a success in March 2015.

Manning stated that he wanted to speak out about his experience to alleviate the stigma that comes with a genital injury or cancer for the benefit of others who have had similar experience. “In 2012, my life changed forever when I suffered a debilitating work accident, followed by a devastating cancer diagnosis. 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 a statement. “In sharing this success with all of you, it’s my hope we can usher in a bright future for this type of transplantation.”