Such transplants “can help those warriors with missing genitalia just as hand and arm transplant transformed the lives of amputees,” Dr. W.P. Andrew Lee, Hopkins’ chairman of plastic and reconstructive surgery, told reporters Monday.
The patient, who asked to remain anonymous, is expected to recover urinary and, eventually, sexual function.
The scrotum transplant did not include the donor’s testicles, meaning reproduction won’t be possible. “We just felt there were too many unanswered ethical questions” with that extra step, said Hopkins’ Dr. Damon Cooney.
Three other successful penis transplants have been reported, two in South Africa and one in 2016 at Massachusetts General Hospital. Those transplants involved only the penis, not extensive surrounding tissue that made this transplant much more complex.
The loss of a penis, whether from cancer, accident or war injury, is emotionally traumatic, affecting urination, sexual intimacy and the ability to conceive a child. Many patients suffer in silence because of the stigma their injuries sometimes carry.
Doctors sometimes reconstruct the form of a penis from a patient’s own skin, usually to treat congenital abnormalities or during transgender surgery. That requires using implants to achieve erection.
For a functional penis transplant, surgeons must connect tiny nerves and blood vessels. Candidates face some serious risks, including rejection of the tissue and side effects from anti-rejection drugs that must be taken for life.
But penis transplants have generated intense interest among veterans from Iraq and Afghanistan, and a few years ago Hopkins surgeons began planning and rehearsing how to perform such a complex operation in patients with widespread tissue damage. The Department of Defense Trauma Registry has recorded 1,367 male service members who survived with genitourinary injuries between 2001 and 2013. It’s not clear how many victims lost all or part of the penis.
Hopkins is screening additional veterans to see if they are good candidates for this type of reconstructive transplant. Finding donors is an additional hurdle: In the U.S., people or their families who agree to donate organs such as the heart or lung must be asked separately about also donating a penis, hand, face or other body part.
The Hopkins patient received an extra experimental step, an infusion of bone marrow from his donor that research suggests may help a recipient’s immune system better tolerate a transplant. Surgeons said that is enabling the veteran to take one anti-rejection drug instead of several.
In a statement from Hopkins, the patient was quoted as saying: “When I first woke up, I felt finally more normal.”
___
The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
Send questions/comments to the editors.
Success. Please wait for the page to reload. If the page does not reload within 5 seconds, please refresh the page.
Enter your email and password to access comments.
Hi, to comment on stories you must . This profile is in addition to your subscription and website login.
Already have a commenting profile? .
Invalid username/password.
Please check your email to confirm and complete your registration.
Only subscribers are eligible to post comments. Please subscribe or login first for digital access. Here’s why.
Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.