John Hopkins University surgeons who worked on the patient's penis and scrotum transplant
John Hopkins University surgeons who worked on the patient's penis and scrotum transplant John Hopkins University

A US veteran has received the world’s first complete transplant of a penis and scrotum. The procedure saw the entire penis, the scrotum (without testicles), and partial abdominal wall transplanted from a deceased donor to the anonymous recipient.

The veteran of the US armed services was injured in Afghanistan. He undertook the surgery on March 26, with the John Hopkins University reconstructive surgery team — composed of nine plastic surgeons and two urological surgeons — operating on him for 14 hours. He is expected to be discharged from the hospital this week after recovering from the surgery.

The reconstructive surgery is the country’s first total penis and scrotum transplant in the world. According to W.P. Andrew Lee, MD, professor and director of plastic and reconstructive surgery at the John Hopkins University School of Medicine, the type of transplant used on the patient is called vascularised composite allotransplantation. It is where a body part or tissue is transferred from one person to another.

The surgery involved the transplanting skin, muscles and tendons, nerves, bone and blood vessels. But as with any transplant surgery, they had feared tissue rejection. They put the patient on a regimen of immunosuppressive drugs to prevent the rejection. The team also developed an immune modulation protocol that aimed to minimise the number of the drugs needed to prevent rejection.

Lee said that although it was possible to reconstruct a penis using tissue from other parts of the patient’s body, a prosthesis implant was necessary for erectile function. Servicemen like the patient also often don’t have viable tissue from other parts of their body to work with. However, prosthesis implant isn’t without faults. It attracts a much higher rate of infection.

“We are hopeful that this transplant will help restore near-normal urinary and sexual functions for this young man,” Lee said.

“It’s a real mind-boggling injury to suffer, it is not an easy one to accept,” said the recipient. “When I first woke up, I felt finally more normal … [with] a level of confidence as well. Confidence… like finally I’m okay now.”

“To the recipient, we are all very proud that our loved one was able to help a young man that served this country. We are so thankful to say that our loved one would be proud and honoured to know he provided such a special gift to you, the donor’s family said in a statement. “As a family, we are very supportive of all the men and women who serve our country and grateful for the job you did for this nation. Please know that this is truly a heart-felt statement, as we have several veterans in the family. We hope you can return to better health very soon and we continue to wish you a speedy recovery.”