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64-year-old man named Thomas Manning, has received a penis from a
deceased donor and become the third penile transplant patient in history
- the first of his kind in the United States.
Cancer survivor Thomas Manning, 64, is the first patient to receive a penis transplant in the U.S.
Doctors at Massachusetts General Hospital performed the first U.S. penis transplant, they said Monday, calling it a "landmark procedure."
Thomas Manning, 64, is recovering well after the 15-hour procedure
performed by a team of over 50 surgeons, doctors and nurses, this month,
according to the hospital. Manning, of Halifax, Massachusetts, had his
penis amputated after he was diagnosed with penile cancer in 2012.
The procedure, also described by the doctors as a "surgical milestone," is called a gentitourinary vascularized composite allograft, or GUVCA.
It involves "surgically grafting the complex microscopic
vascular and neural structures of a donor organ onto the comparable
structures of the recipient."
Put another way, "surgeons connected the intricate vascular and
nerve structures of a donor penis with those of the 64-year-old
transplant recipient," the hospital said.
Dr. Dicken Ko, director of the hospital's Regional Urology Program,
said the objectives of the surgery were primarily to reconstruct the
genitalia so that it appeared natural, followed by urinary function and
hopefully sexual function.
However, Ko added that while sexual function is a goal,
reproduction is not, because of a concern surrounding the ethical issues
of who the potential father may be.
Although Manning is still healing from the surgery, his doctors
said there are no signs of bleeding, rejection or infection, and they
are cautiously optimistic that he will regain function. They expect him
to leave the hospital in the next three or four days.
Surgeons performed the first successful penile transplant
"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 said in a statement provided by the
hospital. He also expressed gratitude to his family and his medical
team, as well as to the family of the donor.
"We are hopeful that these reconstructive techniques will allow
us to alleviate the suffering and despair of those who have experienced
devastating genitourinary injuries and are often so despondent they
consider taking their own lives," said Dr. Curtis L. Cetrulo, a plastic and reconstructive surgeon who led the transplant team along with Ko.
They worked with doctors in infectious disease, psychiatry and
social work and with the New England Organ Bank to identify a suitable
donor.
Cetrulo said the surgery was an effort 3½ years in the making, building on their previous work. "It's
on a continuum of transplants ... hand, face, abdominal wall. ... We
felt comfortable because of our experience with hand transplants," he said.
Manning will need to take immunosupressing drugs for the rest of
his life to diminish any chance of rejection. Certulo added that the
immunosupressants may in fact "help the nerves regrow," hopefully contributing to his success.
Certulo and Ko said they hope that this procedure can help put them on a path to help wounded servicemen. "There's a real patient-driven need," Certulo said.
Eventually, they hope this may even be used with gender reconstruction surgery.
However, Certulo also pointed out that there was still a lot to learn about this process and how it would fit for each patient. "Every case is different. We really had to tailor our procedure to our patient."
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