Overview
On May 4, 2025, surgeons at UCLA performed the first successful human bladder transplant. Oscar Larrainzar, a 41-year-old father of four who'd spent seven years on dialysis after losing his bladder and both kidneys to cancer, received both organs in an eight-hour procedure. The kidney started producing urine immediately. Two days after going home, Larrainzar urinated on his own for the first time in seven years.
The surgery adds the bladder to the short list of organs humans can transplant—a list that hadn't expanded in decades. For carefully selected patients with 'terminal' bladders—those destroyed by cancer, radiation damage, or severe dysfunction—this opens a route that doesn't exist today: replace the organ instead of reconstructing it from intestinal tissue. But significant unknowns remain, including long-term rejection rates and how much immunosuppression patients will need.
Key Indicators
People Involved
Organizations Involved
One of the nation's top-ranked hospitals, home to the world's first bladder transplant program.
USC's urology institute pioneered the preclinical research for bladder transplantation.
The largest organ procurement organization in the U.S., serving 20 million people across Southern California.
Timeline
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OneLegacy Honors Amanda Cordier
CommemorationOneLegacy publicly recognizes Amanda Cordier's organ donation that enabled the historic transplant.
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Success Announced Publicly
AnnouncementUCLA and USC announce successful first human bladder transplant to scientific and medical communities.
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First Independent Urination in Seven Years
MedicalLarrainzar urinates on his own for first time since 2018, marking successful bladder function restoration.
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Patient Discharged from Hospital
MedicalLarrainzar leaves hospital two days after surgery with stable condition and functioning organs.
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First Human Bladder Transplant
SurgeryEight-hour surgery at Ronald Reagan UCLA Medical Center successfully transplants bladder and kidney to Oscar Larrainzar.
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Kidney Function Restored Immediately
MedicalNew kidney produces large urine volume immediately; patient requires no dialysis post-surgery; urine drains properly into new bladder.
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Amanda Cordier's Organs Matched
DonationOneLegacy matches Amanda Cordier's organs to five recipients, including Oscar Larrainzar for bladder-kidney transplant.
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Clinical Trials Launch
Clinical TrialUCLA (NCT06337942) and USC (NCT05462561) launch parallel clinical trials enrolling patients for bladder or kidney-bladder transplants.
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Brain-Dead Donor Trials Completed
ResearchFive successful robotic bladder transplantations performed in heart-beating brain-dead research donors at USC facilities.
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Cadaver Practice Surgeries Begin
ResearchTeam completes first robotic bladder retrievals in human cadavers, discovering robotic approach superior for pelvic vascular work.
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Bladder Transplant Research Begins
ResearchNassiri and Gill initiate four-year research program to develop bladder transplantation techniques, starting with porcine models.
Scenarios
Bladder Transplants Become Standard of Care for Terminal Bladder Disease
Discussed by: UCLA and USC medical teams, transplant medicine journals, urology publications
If the ongoing clinical trials demonstrate consistent success with manageable rejection rates, bladder transplantation could become a standard option for carefully selected patients with terminal bladder dysfunction. This would require UNOS to establish allocation policies for bladders, expanding the organ donation system. Current alternatives—neobladder reconstruction using intestinal tissue—carry complications including infection, internal bleeding, and digestive problems. A true bladder transplant could offer better quality of life outcomes. Four more surgeries are planned; if similarly successful, larger trials will follow. Success depends on proving that long-term immunosuppression risks don't outweigh benefits for patients not already requiring it.
Procedure Remains Limited to Niche Multi-Organ Cases
Discussed by: Medical ethicists, transplant surgeons, organ allocation policy experts
The complexity and unknowns may confine bladder transplants to rare cases: patients already on immunosuppression from previous transplants, or those needing combined kidney-bladder procedures like Larrainzar. The bladder's complex pelvic vascular anatomy makes surgery technically demanding. More critically, asking patients to accept lifelong immunosuppression—with risks of infection, cancer, and organ damage—is hard to justify when neobladder reconstruction from their own tissue remains an option. Unless transplants prove dramatically superior in quality of life and longevity, most surgeons may stick with existing reconstructive techniques that don't require anti-rejection drugs or donor organs.
Rejection Issues Derail Clinical Trials
Discussed by: Transplant immunology researchers, medical publications tracking trial outcomes
The immune response to a transplanted bladder remains poorly understood. Unlike kidneys or hearts, where immunosuppression protocols are well-established after decades of practice, bladder transplantation is uncharted territory. If early patients experience severe rejection despite immunosuppression, or if the drugs required are too toxic, trials could pause or end. Bladder tissue constantly interfaces with urine and bacteria, potentially complicating rejection and infection dynamics. The two-year trial follow-up period may reveal long-term complications invisible in Larrainzar's immediate success. Failed organs would require removal and return to neobladder reconstruction—a major setback for patients who took the experimental gamble.
Historical Context
First Successful Kidney Transplant (1954)
1954What Happened
Dr. Joseph Murray at Brigham & Women's Hospital transplanted a kidney between identical twin brothers, eliminating rejection risk. The recipient lived eight more years. This established the technical foundation for all future solid organ transplantation, though non-twin transplants remained impossible until immunosuppression drugs were developed in the 1960s.
Outcome
Short term: Proved organ transplantation was surgically feasible and could extend life.
Long term: Launched the entire field of transplant medicine; kidney transplants now routine with over 25,000 performed annually in the U.S.
Why It's Relevant
Like the 1954 kidney breakthrough, the 2025 bladder transplant opens a new category of organ replacement—but faces the same question: can it scale beyond the first success?
First Heart Transplant (1967-1968)
1967-1968What Happened
Dr. Christiaan Barnard transplanted the first human heart in Cape Town in December 1967; the patient lived 18 days. Dr. Norman Shumway followed with the first U.S. heart transplant at Stanford in 1968. Early mortality was high due to rejection and infection. Programs nearly shut down until better immunosuppression drugs emerged in the 1980s.
Outcome
Short term: Initial failures nearly ended heart transplantation; only a few centers persisted through the 1970s.
Long term: Heart transplants are now routine with over 3,500 performed annually in the U.S. and one-year survival rates above 90%.
Why It's Relevant
The bladder transplant's immediate success echoes early heart transplant optimism—but that field endured a decade of failure before becoming viable.
First Lung Transplant Success (1983)
1983What Happened
Dr. Joel Cooper performed the first successful single lung transplant at Toronto General Hospital after two decades of failed attempts by other surgeons. Previous failures stemmed from poor healing of the bronchial connection and infection. Cooper's technique innovations finally solved these problems.
Outcome
Short term: Patient survived and breathed independently, validating years of experimental work.
Long term: Lung transplants now save thousands annually, though they remain the most technically challenging solid organ transplants with highest rejection rates.
Why It's Relevant
The bladder shares the lung's challenge: constant exposure to bacteria and foreign material (urine vs. air), which may complicate long-term graft survival.