Surgeons at Massachusetts General Hospital in Boston performed the first reconstructive penile transplant in the nation this month. Thomas Manning, 64, of Halifax, Mass, underwent a 15-hour operation to connect the arteries, veins, nerves, urethra, and skin graft pedicle to form an anatomically correct penis. Blood flow was established to the donor organ with no signs of bleeding, rejection, or infection.
The intricate surgery involved a large team of more than 30 health care professionals. There were 7 attending surgeons, 6 fellows or residents, anesthesiologists, nurses, physician assistants, scrub nurses, circulators, and organ bank personnel. Clinical experience in microvascular grafting, cadaveric labs for anatomic dissections, and genitourinary donor procurements all informed the transplant protocol.
According to the physicians, the patient will regain urinary function and possibly sexual function. The testes were not transplanted, so reproduction is not a major concern. Since the risk of organ rejection is 6%-18% in the first year, Manning will receive immunosuppressive therapies.
A diagnosis of penile cancer in 2012 led Manning to undergo a partial penectomy, which eventually led to the transplant:
“In 2012, my life changed forever when I suffered a debilitating work accident, followed by a devastating cancer diagnosis,” Manning said in a press release issued by Mass General. “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.”
A urologic surgeon from Walter Reed National Military Medical Center with experience dealing with genitourinary injuries of wounded warriors formed part of the team that developed the surgical protocol.
- First Genitourinary Vascularized Composite Allograft (Penile) Transplant in the Nation Performed at Massachusetts General Hospital [news release]. Massachusetts General Hospital, May 16, 2016.