(CNN) – The world's first successful total penile and scrotal grafting was completed at the Johns Hopkins Hospital on March 26, a press release released Monday said.
The procedure lasted 14 hours and included nine plastic surgeons, two urological surgeons and a team of anesthesiologists. Nurses and surgical technicians, according to the publication. The transplant recipient, who wanted to remain anonymous, is a young US soldier who sustained injuries to his lower pelvis, lower abdominal wall, and lower extremities during his mission in Afghanistan through an improvised explosive blast.
"While war wounds cause great suffering, disfigurement and disability, they have also fueled medical discoveries," Dr. Andrew Lee, chairman of the Department of Plastic and Reconstructive Surgery at Johns Hopkins University and one of the surgeons in this case, in a press conference.
"While limb amputations are visible and the resulting disability is obvious, some war injuries are hidden and their effects are not appreciated by others," Lee added. "Urogenital injuries in which the male genitalia are lost or severely damaged are one such" unspoken war injury. "
In order to perform the transplant, the team needed the required tissue – consisting of a penis, scrotum, and part of the lower abdominal wall – obtained from a deceased donor Rick Redett, clinical director of the Johns Hopkins Urogenital Transplantation Program and another surgeon on the case.
"In order to perform the graft, we have obtained the necessary tissue from the donor to restore the normal anatomy of the recipient," Redett said in a statement.
Three arteries, four veins and two nerves were connected during the procedure A microscopic guide to give the transplanted tissue adequate blood flow and sensitivity, said Retett
The donor testes and vas deferens – which produce and transport sperm – but were not transplanted for ethical reasons, said Dr Gerald Brandacher, scientific director of the Composite Tissue Allotransplantation Program at Johns Hopkins and a surgeon on the case.
"For ethical reasons, we do not want to transplant the germ line from the donor, because that would mean that when the recipient bears a child, the child's genetic background actually comes from the donor and not from the recipient," said Brandacher. "But in a second step, the patient will get testicular prostheses."
According to Lee, the transplant is the culmination of more than five years of research and collaboration between various medical disciplines at Johns Hopkins
"In 2013" We have assembled a team of plastic surgeons, urologists, transplant specialists, psychologists and bioethicists and started preparing for a urogenital transplant, "he said.
" We performed multiple surgical transplants on corpses, refined our techniques, and designed a transplantation and transplant plan. "
In 2014, the first successful penile grafting in South Africa was performed by a team of doctors at Stellenbosch University in Cape Town and Tygerberg Hospital, but the current case is the first to involve scrotum and lower abdominal wall grafting Lee.
"Our surgical team, consisting of nine plastic surgeons and two urological surgeons, led the world's first total penile and scrotal grafting," Lee said. "I want the skills and dedication of doctors, nurses, and staff from Johns Hopkins, who were essential to this groundbreaking procedure. "
Transplantation is an example of a type of vascular composite allograft or VCA. VCA refers to the transplantation of multiple types of tissues such as skin, muscles, and bones, according to the American Society of Transplantation often on the transplantation of body parts like arms, hands, faces and – now – genitals.
"These life-altering VCA grafts can only occur when a donor family leaves their mourning behind and gives it to someone in need," said Alexandra Glazier, president of New England Donor Services, in a statement.
New England Donor Services is a federally designated organization that helps coordinate organ and tissue transplants in the Northeast, Glazier said.
"Since 2009, New England Donor Services has requested and received 13 families' approval for a VCA donation, resulting in the transplantation of 19 VCA grafts," she added. "In this case, we worked closely with our colleagues from the Living Legacy Foundation, the organ care organization that serves most of Maryland, to facilitate and coordinate the recovery of this unique donation for the Hopkins team's transplantation."
the Comprehensive Transplant Center at Johns Hopkins was a pioneer in many of the recent advances in VCA procedures.
"Just over five years ago, the first quadruple amputee survivor in Iraq, US Army Sgt. Brendan Marrocco, received a double arm transplant from Johns Hopkins," said Lee. "And just over five months ago, our team transplanted two new arms into Army National Guard Sgt. Eric Lund, who lost both arms under his shoulders from a road bomb in Afghanistan."
Nearly a month after the procedure, the peni transplant recipient appears to be recovering well and is expected to be discharged by the end of this week, Redett said.
"Our patient is recovering from the transplant, he is walking, and the graft shows no signs of infection or rejection," said Redett. "It is our hope that such a life-enhancing transplant will allow him to regain the urinary and sexual function and lead a more normal life."
It is expected that the patient will regain full sexual and urinary function in the coming months, although, according to Brandacher, he will not be able to produce sperm.
"All the research that we have done and all the experience we have made has clearly indicated from our urology colleagues that he will regain the full function of the penis in relation to urinating … by one Having an erection and having sexual intercourse, "said Brandacher.
Following the announcement of the operation, the donor family, which was also unnamed, issued a statement thanking the recipient for his efforts: "We are all very proud that our lover could help a young man so grateful to say that our beloved person would be proud and honored to know that he has given you such a special gift. As a family, we support all the men and women who serve our country and are grateful for the work you have done this nation has done. "