Health
Surgeons Perform First Human Bladder Transplant

Surgeons in Southern California have performed the first human bladder transplant, introducing a new, potentially life-changing procedure for people with debilitating bladder conditions.
The operation was performed earlier this month by a pair of surgeons from the University of California, Los Angeles, and the University of Southern California on a 41-year-old man who had lost much of his bladder capacity from treatments for a rare form of bladder cancer.
“I was a ticking time bomb,” the patient, Oscar Larrainzar, said on Thursday during a follow-up appointment with his doctors. “But now I have hope.”
The doctors plan to perform bladder transplants in four more patients as part of a clinical trial to get a sense of outcomes like bladder capacity and graft complications before pursuing a larger trial to expand its use.
Dr. Inderbir Gill, who performed the surgery along with Dr. Nima Nassiri, called it “the realization of a dream” for treating thousands of patients with crippling pelvic pain, inflammation and recurrent infections.
“There is no question: A potential door has been opened for these people that did not exist earlier,” said Dr. Gill, the chairman of the urology department at U.S.C.
Pushing the Envelope
Until now, most patients who undergo a bladder removal have a portion of their intestine repurposed to help them pass urine. Some receive an ileal conduit, which empties urine into a bag outside the abdomen, while others are given a so-called neobladder, or a pouch tucked inside the body that attaches to the urethra and allows patients to urinate more traditionally.
But bowel tissue, riddled with bacteria, is “inherently contaminated,” Dr. Gill said, and introducing it to the “inherently sterile” urinary tract leads to complications in up to 80 percent of patients, ranging from electrolyte imbalances to a slow reduction in kidney function. The loss of the intestinal segment can also cause new digestive issues.
Dr. Despoina Daskalaki, a transplant surgeon at Tufts Medical Center who was not involved in the new procedure, said advances in transplant medicine (from critical life-sustaining organs, like hearts and livers, to other body parts, like faces, hands, uteri and penises) had led doctors to start “pushing the envelope.”
“They’re asking: ‘Why do we have to put up with all the complications? Why don’t we try and give this person a new bladder?’” Dr. Daskalaki said.
In late 2020, Dr. Nassiri was in his fourth year of residency at the University of Southern California when he and Dr. Gill sat down in the hospital cafeteria to begin brainstorming approaches. After Dr. Nassiri began a fellowship on kidney transplantation at U.C.L.A., the two surgeons continued working together across institutions to test both robotic and manual techniques, practicing first on pigs, then human cadavers, and finally, human research donors who no longer had brain activity but maintained a heartbeat.
One of the challenges of transplanting a bladder was the complex vascular infrastructure. The surgeons needed to operate deep inside the pelvis of the donor to capture and preserve a rich supply of blood vessels so the organ could thrive inside the recipient.
“When we’re removing a bladder because of cancer, we basically just cut them. We do it in less than an hour on a near-daily basis,” Dr. Gill said. “For a bladder donation, that is a significantly higher order of technical intensity.”
The surgeons also chose to conjoin the right and left arteries — as well as the right and left veins — while the organ was on ice, so that only two connections were needed in the recipient, rather than four.
When their strategy was perfected in 2023, the two drew up plans for a clinical trial, which eventually would bring the world’s first recipient: Oscar.
An Ideal First Candidate
When Mr. Larrainzar walked into Dr. Nassiri’s clinic in April 2024, Dr. Nassiri recognized him. Almost four years earlier, Mr. Larrainzar, a husband and father of four, had been navigating end-stage kidney disease and renal cancer, and Dr. Nassiri helped remove both of his kidneys.
But Mr. Larrainzar had also survived urachal adenocarcinoma, a rare type of bladder cancer, and a surgery to resect the bladder tumor had left him “without much of a bladder at all,” Dr. Nassiri said. A normal bladder can hold more than 300 cubic centimeters of fluid; Mr. Larrainzar’s could hold 30.
Now, years of dialysis had begun to fail; fluid was building up inside his body. And with so much scarring in the abdominal region, it would have been difficult to find enough usable length of bowel to pursue another option.
“He showed up serendipitously,” Dr. Nassiri said, “but he was kind of an ideal first candidate for this.”
On a Saturday night earlier this month, Dr. Nassiri received a call about a potential bladder match for Mr. Larrainzar. He and Dr. Gill drove straight to the headquarters of OneLegacy, an organ procurement organization, in Azusa, Calif., and joined a team of seven surgeons working overnight to recover an array of organs from a donor.
The two brought the kidney and bladder to U.C.L.A., then stopped home for a shower, breakfast and a short nap. They completed the eight-hour surgery to give Mr. Larrainzar a new bladder and kidney later that day.
Dr. Nassiri said that kidney transplants can sometimes take up to a week to process urine, but when the kidney and bladder were connected inside Mr. Larrainzar, there was a great connection — “immediate output” — and his creatinine level, which measures kidney function, started to improve immediately. Mr. Larrainzar has already lost 20 pounds of fluid weight since the surgery.
The biggest risks of organ transplantation are the body’s potential rejection of the organ and the side effects caused by the mandatory immune-suppressing drugs given to prevent organ rejection. That is why, for Dr. Rachel Forbes, a transplant surgeon at Vanderbilt University Medical Center who was not involved in the procedure, the excitement is more tempered.
“It’s obviously a technical advance,” she said, but “we already have existing options for people without bladders, and without the downside of requiring immunosuppression.” Unless a patient is — like Mr. Larrainzar — going to be on those medications anyway, “I would be a little bit nervous that you would be exchanging some complications for others,” she said.
A new bladder transplant also does not have nerve connections in the recipient, so while it works well as a storage organ, doctors did not know whether Mr. Larrainzar would ever be able to sense a full bladder, let alone hold and empty it naturally. They spoke about catheters, abdomen maneuvers and eventually developing an on-demand bladder stimulator to help with the release.
But at a follow-up appointment on Thursday morning — just two days after Mr. Larrainzar was discharged from the hospital — Dr. Nassiri removed the catheter and gave him fluids, and Mr. Larrainzar immediately felt that he could urinate.
Dr. Nassiri called it a miracle, then phoned Dr. Gill, who was in a U.S.C. operating room, and exclaimed two words: “He peed!”
“No way! What the hell?” Dr. Gill said. “My jaw is on the floor.”
After finishing the surgery, Dr. Gill drove straight to U.C.L.A. and watched Mr. Larrainzar do it again.
“Of course, this is very, very early. Let’s see how everything goes,” Dr. Gill cautioned. “But it’s the first time he has been able to pee in seven years. For all of us, this is huge.”
Mr. Larrainzar, exhausted, smiled, and Dr. Nassiri brought him a bottle of mineral water to celebrate.

Health
Video: Trump Pushes Unproven Link Between Tylenol and Autism

new video loaded: Trump Pushes Unproven Link Between Tylenol and Autism
By Azeen Ghorayshi, Claire Hogan, Theodore Tae and June Kim•
Top U.S. health officials urged pregnant women not to use acetaminophen, the active ingredient in Tylenol, claiming it could cause autism, though studies have been inconclusive. Azeen Ghorayshi, a science reporter for The New York Times, explains.
Health
Autism by the numbers: Experts share reasons for the dramatic surge in diagnoses

NEWYou can now listen to Fox News articles!
Monday’s sweeping autism announcements have sparked deeper conversations about the widespread neurological disorder.
Health officials spoke during a press conference in Washington, D.C., about possible causes, vaccine guidance and the potential for a cancer drug to double as an autism therapy.
Autism diagnoses have been steadily rising in recent decades, according to the Centers for Disease Control and Prevention.
AUTISM SPECTRUM IN ADULTS HAS COMMONLY OVERLOOKED SYMPTOMS, EXPERTS WARN
“In the 1970s, autism was considered rare, perhaps 1 in 5,000 to 10,000 children,” Steven Quay, M.D., Ph.D., a physician-scientist and founder of Atossa Therapeutics in Seattle, Washington, told Fox News Digital.
In the year 2000, an estimated one in 150 children aged 8 had the disorder. By 2010, that number had risen to one in 68 — and by 2022, one in 31 children were diagnosed.
Autism diagnoses have been steadily rising in recent decades, according to the Centers for Disease Control and Prevention. (iStock)
“Autism is no longer an uncommon condition tucked away in psychiatric textbooks,” said Quay. “It is part of the daily fabric of schools, clinics and families everywhere.”
Dr. Aggie Papazyan, a Los Angeles-based psychologist specializing in autism spectrum disorder, noted that autism prevalence has also increased globally.
CANCER DRUG COULD DOUBLE AS AUTISM THERAPY, AND IS POISED FOR FDA APPROVAL
“These rates vary by region,” she told Fox News Digital. “In many places, especially in higher-income settings with more robust diagnostic and health resources, prevalence estimates have gone up.”
She added, “However, it’s important to note that how autism is measured makes a big difference.”
Awareness vs. epidemic
The CDC has noted that improved identification of autism could be part of the increase, but that other factors could also come into play.
Decades ago, many autistic people were “missed, misdiagnosed or labeled differently,” said Papazyan.
“There doesn’t seem to be a sudden surge in biological incidence.”
“Over time, as awareness has grown, diagnostic definitions expanded and screening became a bit more routine — so it’s not a surprise to see more autism diagnoses,” she said.
“The biggest misconception is that rising numbers mean autism itself is suddenly becoming more common,” the expert went on. “That’s scary to some people, but there’s no new autism ‘epidemic.’”

Experts say more funding is needed for early intervention programs, such as speech, occupational and behavioral therapies. (iStock)
Most of the increase, according to Papazyan, is due to earlier intervention, broader diagnostic criteria and improved access to services.
“There doesn’t seem to be a sudden surge in biological incidence,” she added. “There may still be a true rise, but it’s not as dramatic as many people want to think.”
Quay said it would be “naïve” to assume that the rise is due only to better detection, and said that environmental change also plays a role.
“Fifty years ago, many individuals on the spectrum were mislabeled — sometimes as intellectually disabled, sometimes as ‘eccentric’ or ‘odd,’ but I do not believe this accounts for the entire increase,” he said.

To counter the rising autism diagnoses, experts call for increasing awareness and acceptance while reducing stigma. (iStock)
“Environmental influences, from prenatal exposures to changes in maternal health to shifts in early childhood experiences, likely play some role.”
‘Urgent need’
To counter the rising autism diagnoses, Papazyan is calling for increasing awareness and acceptance while reducing stigma, as this affects how resources are allocated.
“Beyond that, we need to expand diagnostic and assessment services, especially in underserved communities, so that people are properly diagnosed and given the care they need,” she said.
Papazyan said more funding is also needed for early intervention programs, such as speech, occupational and behavioral therapies.
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The experts also agreed that support is needed for autistic people as they get older, including mental health services, financial assistance and life skills development.
“Interventions are needed that go beyond childhood, because autistic adults will spend most of their lives outside the school system, yet services for them are almost nonexistent,” said Quay.
“Fifty years ago, many individuals on the spectrum were mislabeled.”
Looking ahead, Papazyan predicts that autism prevalence will continue to increase over the next few years before it slows down and eventually hits a plateau.
Quay also expects that prevalence will continue to rise in the near term, largely due to improvements in detection and “societal willingness to diagnose.”
For more Health articles, visit www.foxnews.com/health
“Whether there is a biological plateau remains to be seen,” he said. “If environmental contributors are identified and mitigated, we could see stabilization.”
Health
Who Makes Vaccine Policy Decisions in RFK Jr.’s Health Department?

For decades, as an activist, Robert F. Kennedy Jr. resisted the scientific consensus that vaccines are safe and necessary to prevent serious disease. Now at the helm of the nation’s health department, he has begun to put his extreme views into practice, ousting veteran scientists and installing allies across the nation’s health agencies to enact major shifts in vaccine policy.
Some of Mr. Kennedy’s hires are activists who have worked for years alongside him. Others are scientists who say they broadly support vaccines but publicly criticized Covid shots or mandates during the pandemic. Many of these scientists have begun to question the safety or value of other shots, reflecting the views of Mr. Kennedy. The following account is based on previous statements made by these officials and on interviews with current and former health agency leaders.
F.D.A. chief medical and scientific officer
Critical of Covid boosters and shots for healthy kids
F.D.A. commissioner
Skeptical of certain vaccines
Dr. Vinay Prasad
Dr. Marty Makary
The agency’s new vaccine lead and chief medical officer, Dr. Vinay Prasad, has called himself an “extreme pro-vaccine person,” and Dr. Marty Makary, the agency’s commissioner, said last week that “we believe in vaccines.”
But the two officials, who sharply criticized vaccine mandates as academic researchers during the pandemic, have expressed doubts about the safety and necessity of Covid boosters for healthy children and adults. This summer, Dr. Prasad overrode some agency scientists who favored widespread access to Covid shots, narrowing the vaccine’s eligibility to those 65 and older and to younger people with underlying medical conditions.
Last week, Dr. Makary echoed the views of Mr. Kennedy when he publicly questioned the longstanding recommendation to give the hepatitis B vaccine at birth. That shot is credited with nearly eliminating the transmission of the disease from mother to infant.
Dr. Prasad replaced a veteran at the agency, Dr. Peter Marks, who resigned in March and said that Mr. Kennedy’s aggressive stance on vaccines posed a danger to the public.
In June, Mr. Kennedy fired all 17 members of a powerful C.D.C. expert panel, the Advisory Committee on Immunization Practices. Insurance companies and government programs like Medicaid are required to cover the vaccinations that the panel recommends.
Mr. Kennedy handpicked eight new members that month, half of whom had expressed skepticism of vaccines at some point. (One has since stepped down.) Others have little expertise in immunology or vaccines.
On Monday, Mr. Kennedy appointed five more members, just days before the group meets to review recommendations for multiple vaccines. Some of the newly selected members have been critical of Covid vaccines or vaccine mandates.
Dr. Robert Malone is a controversial figure. He performed early experiments using mRNA in the 1980s but gained notoriety during the pandemic for claiming that Covid vaccines were unsafe, contradicting volumes of studies.
Martin Kulldorff, a biostatistician, has been generally supportive of vaccines but opposed Covid vaccination for children and vaccine mandates. Vicky Pebsworth, a nurse with a doctorate in public health, serves on the board of the National Vaccine Information Center, a nonprofit that disseminates misinformation about the risks of vaccination.
Dr. Malone and Dr. Kulldorff have served as paid expert witnesses in legal cases against vaccine makers. Dr. Pebsworth claimed in a lawsuit that a survey of families of unvaccinated children supported a hypothesis that a rise in the number of recommended childhood vaccines explained an epidemic of chronic disease.
Another panel member, Retsef Levi, is a management and health analytics expert at the Massachusetts Institute of Technology. He has been critical of a variety of vaccines and has called for Covid vaccines to be pulled from the market.
Dr. Evelyn Griffin, an obstetrician and gynecologist, questioned the safety and effectiveness of Covid vaccines in a hearing in the Louisiana House of Representatives in 2021. Dr. Kirk Milhoan, a pediatric cardiologist, questioned the safety and effectiveness of Covid vaccines at a 2024 event led by Representative Marjorie Taylor Greene, Republican of Georgia. Catherine M. Stein is an epidemiology professor who in 2022 called for an end to Covid vaccine mandates at universities.
Dr. Cody Meissner is a professor of pediatrics who opposed vaccine mandates and has questioned the ongoing need for Covid vaccines for children and pregnant women. He previously served on the advisory committee and is widely considered to be the most qualified member.
The others are not known to have spoken out against vaccines. They are Dr. Joseph R. Hibbeln, a nutritional neuroscientist; Dr. James Pagano, an emergency medicine physician; Hillary Blackburn, a pharmacist; and Dr. Raymond Pollak, a surgeon and transplant specialist.
The C.D.C. director has the power to accept or reject the immunization committee’s recommendations. The current acting director is Mr. Kennedy’s deputy at the Department of Health and Human Services, Jim O’Neill, a former biotechnology executive. The previous director, Susan Monarez, said she was forced out because she would not agree to accept the newly re-formed committee’s recommendations.
A special adviser to the C.D.C. director, Stuart Burns, is a critical player driving the health secretary’s agenda at the agency. Mr. Burns has been quietly working to remake the immunization committee and its agenda.
Mr. Burns is not a scientist but he worked for decades as a staff member for Republican congressmen known for their vaccine skepticism. One is Dr. Dave Weldon, a former representative from Florida who was also Mr. Kennedy’s original choice for C.D.C. director. The White House withdrew Dr. Weldon’s nomination just hours before his confirmation hearing because some Senate Republicans were concerned about his stance on vaccines.
Mr. Burns works closely with three other Kennedy hires who serve H.H.S. but also work closely with the C.D.C. Dr. Reyn Archer is a former Texas health commissioner who has questioned the safety and value of the Covid vaccine on social media. He serves as a liaison between the health secretary’s office and the C.D.C., and has been helping Mr. Burns to develop and guide the immunization committee.
David Geier is a steadfast figure in the anti-vaccine movement who has spent more than 20 years trying to establish a link between vaccines and autism, despite scientific consensus that there is none. Mr. Geier, who is listed as a senior data analyst in the H.H.S. directory, was given access to federal data on post-vaccination side effects and is using it to continue his studies on autism.
Lyn Redwood is a nurse practitioner and the former head of Children’s Health Defense, the anti-vaccine group founded by Mr. Kennedy. Since the early 2000s, Ms. Redwood has criticized the use of mercury as a preservative in vaccines. She has said she believes the ingredient is linked to her son’s autism.
Now listed as an expert at H.H.S., Ms. Redwood gave a presentation in June to the immunization committee, a role usually reserved for C.D.C. scientists. She said that the mercury preservative in vaccines, known as thimerosal, was toxic to children, even though dozens of studies have shown it is harmless in this form. The panel later voted to stop recommending the already limited number of flu vaccines that contained the preservative.
Principal deputy director of the N.I.H.
Skeptical of certain vaccines
N.I.H. director
Critical of Covid vaccine mandates
Dr. Matthew Memoli
Dr. Jay Bhattacharya
Dr. Matthew Memoli is a veteran infectious disease scientist at the National Institutes of Health who now serves as its principal deputy director. As a senior researcher under Dr. Anthony Fauci during the pandemic, Dr. Memoli opposed Covid vaccine mandates and declined to get a shot himself.
Since becoming a leader of the research agency, Dr. Memoli has downplayed the value of vaccines for certain respiratory diseases, according to the whistle-blower complaints of two prominent scientists.
Dr. Jay Bhattacharya, the N.I.H director, sharply criticized vaccine mandates as an academic researcher during the pandemic. He co-wrote an anti-lockdown treatise in 2020 with Dr. Kulldorff, one of Mr. Kennedy’s selections for the C.D.C. immunization committee.
During his confirmation hearing in March, Dr. Bhattacharya reiterated his support for childhood vaccinations for diseases like measles. He also said he was “convinced” vaccines did not cause autism, even as he urged more research on the question, which scientists say has long been settled.
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