In the announcement of the second successful transplant, Zarrabi and his colleagues detailed the technically complex procedure, which required a team of surgeons performing a nine-hour operation. The recipient was a 40-year-old male who had lost his penis 17 years ago due to complications after a traditional circumcision.
Microsurgical techniques are used to connect blood vessels, nerves, muscles, and the urethra, allowing the patient to urinate through the penis. The transplant also requires restoring blood flow to the corpus cavernosum, the interior tissue of the penis that enables the recipient to maintain an erection.
The procedure has many other complications. The patient must be able to tolerate a regimen of immunosuppression medication during and after the transplant. To color match the exterior skin tissue, doctors plan to use a kind of medical tattooing procedure, which requires a specially trained artist.
Then there is the matter of donors.
"The lack of penis transplants across the world since we performed the first one in 2014 is mostly due to a lack of donors,” said Dr. André van der Merwe, who led the surgical team. “We are extremely grateful to the donor's family who so generously donated not only the penis, but also the kidneys, skin, and corneas of their beloved son.”
And because the penis transplant procedure is experimental, ethics rules require that recipients undergo months of counseling both before and after the surgery.
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All of these elements add up to a very costly enterprise. The second transplant operation was designed, in part, as a proof-of-concept study to determine how expenses can be brought down.
“We are committed to finding cost-effective solutions to help these men," said Van der Merwe.
As for our latest penile transplant recipient, all indications are that the patient is doing remarkably well. According to the hospital officials all urinary and reproductive functions should be restored within six months.
“There are no signs of rejection and all the reconnected structures seem to be healing well," said Van der Merwe. "He is certainly one of the happiest patients we have seen in our ward.”
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