In a historic advancement for organ transplantation, surgeons from USC and UCLA have successfully completed the world’s first human bladder transplant.
The groundbreaking procedure took place on May 4, 2025, at Ronald Reagan UCLA Medical Center. It offers new hope for individuals with severely impaired bladder function—patients who previously had few effective treatment options. During the eight-hour surgery, the medical team transplanted both a kidney and a bladder into a patient who had spent seven years on dialysis after losing most of his bladder to cancer.
This milestone is the result of four years of rigorous planning and collaboration between Dr. Inderbir Gill of USC Urology and Dr. Nima Nassiri, a urologic transplant surgeon at UCLA Health. Their pioneering work opens the door to transformative care for millions suffering from serious bladder disorders.
A Potential Lifeline for Patients
For people struggling daily with the challenges of a non-functioning bladder, this advancement could mean a significant improvement in quality of life. Until now, patients had to rely on complex and often problematic alternatives, including the use of intestinal tissue to construct bladder substitutes.
“This surgery marks a pivotal moment in medical history,” said Dr. Gill, Chair and Distinguished Professor of Urology at the Keck School of Medicine of USC. “It has the potential to change how we treat patients with severely symptomatic and functionally ‘terminal’ bladders. Bladder transplantation can now be considered alongside other life-enhancing organ transplants.”
The transplant recipient had lost most of his bladder in cancer surgery over five years ago, rendering the remaining tissue unusable. Following a later diagnosis of renal cancer, both of his kidneys were removed, leaving him dependent on dialysis.
A Carefully Orchestrated Procedure
In this dual-organ transplant, surgeons first implanted the kidney, then the bladder, before connecting the two so that urine produced by the kidney could drain into the new bladder. The results were immediate and impressive.
“The kidney began producing large volumes of urine right away, and its function improved immediately,” said Dr. Nassiri. “There was no need for dialysis after surgery, and the new bladder handled urine drainage effectively.”
Key Advantages Over Traditional Treatments
This transplant approach offers several benefits over current methods:
- Provides a natural urinary reservoir, unlike substitutes made from intestinal tissue
- Reduces risk of chronic urinary tract infections
- Avoids digestive issues linked to intestine-based reconstructions
- Better preserves kidney function
- Enables more normal urine storage and voiding
A Breakthrough Years in the Making
The success of this operation follows years of careful development. Dr. Nassiri, now an assistant professor of urology and kidney transplantation at UCLA and formerly a resident at USC, worked with Dr. Gill to refine the surgical approach, launch a clinical trial, and obtain the necessary approvals.
“This transplant represents over four years of preparation,” said Dr. Nassiri. “For the right patient, it could offer a game-changing solution.”
Prior to operating on a human, the team conducted numerous trial surgeries at Keck Medical Center of USC. These included robotic bladder retrievals and transplant procedures performed on recently deceased donors maintained on ventilators.
Perfecting the Technique Through Trial Runs
To ensure surgical precision, additional non-robotic trial procedures for bladder recovery were conducted at OneLegacy, Southern California’s organ procurement organization. These practice sessions allowed the surgical team to refine their technique in collaboration with multidisciplinary teams, laying the groundwork for a safe and successful human transplant.
A New Option for Millions Living with Bladder Dysfunction
Bladder dysfunction affects millions worldwide, with some individuals developing what are known as “terminal bladders”—organs so damaged they cause chronic pain, frequent infections, and severe complications. Current surgical options for these patients often involve reconstructing a bladder using parts of the intestine or creating alternative urinary pathways.
“While those surgeries can help, they come with significant long-term risks—recurrent infections, impaired kidney function, and digestive problems, to name a few,” explained Dr. Gill.
“In contrast, a bladder transplant offers a more natural, functional urinary reservoir,” added Dr. Nassiri. “It may help avoid many of the issues linked to intestine-based solutions.”
Looking Ahead: Challenges and Opportunities
As with all organ transplants, the risk of rejection and the side effects of lifelong immunosuppressive medications remain major challenges. For now, the ideal candidates for bladder transplantation are patients who already require immunosuppression—such as those receiving a kidney transplant at the same time.
While there are still unanswered questions—like how a transplanted bladder performs long-term and how to best balance immunosuppressive therapy—the surgical team is optimistic about the future.
“Our goal is to find out whether bladder transplantation can meaningfully improve life for patients with severely impaired bladders,” said Dr. Gill.
This historic transplant was performed as part of a UCLA clinical trial. Both surgeons hope to expand the program and perform additional bladder transplants in the near future. The achievement highlights USC Urology’s legacy of leadership in robotic urologic surgery and UCLA Health’s world-class expertise in transplantation medicine.
For millions affected by severe bladder dysfunction, this medical first represents more than a surgical milestone—it offers a potential path to restored health, independence, and dignity.