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.
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High-dose vitamin B3 (niacin) may enhance immune activity and improve short-term disease control in glioblastoma when added to standard therapy, according to early preclinical studies.
Glioblastoma is a highly aggressive, fast-growing brain cancer that develops from cells in the brain and spinal cord.
In previous laboratory experiments in mice, niacin was shown to extend survival. Researchers at the University of Calgary aimed to determine whether that same benefit extended to humans.
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The trials included 24 patients with glioblastoma, which has a median survival of roughly 12 to 18 months.
Six months after receiving niacin in addition to standard treatments (surgery, radiation and chemotherapy), 82% of the patients showed no disease progression, compared to the typical 54%, according to the study’s press release.
Left to right: Edward (Ed) Waldner (study participant), Dr. Wee Yong, PhD, (scientist), Dr. Gloria Roldan Urgoiti, MD, (oncologist) (Riley Brandt, University of Calgary)
Niacin was also found to restore function in weakened immune cells, improving their ability to target and destroy tumor cells.
The findings, including the 28% improvement in disease progression, were published in the Journal of Neuro-Oncology.
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“Normally, the immune system will try to counter and prevent tumor growth; however, this brain cancer suppresses the immune system,” said study author Dr. Wee Yong, PhD, a neuroscientist who studies immune responses in the brain, in the release. “Niacin treatment rejuvenates immune cells so they can do what they are supposed to do: attack and kill the cancer cells. I see it as an ongoing ‘battle for the brain.’”
Looking ahead, the team plans to enroll an additional 24 patients by the end of 2026 or early 2027 for the next phase of the trial, which will assess niacin’s safety and immune system activation.
Niacin was found to restore function in weakened immune cells, improving their ability to target and destroy tumor cells. (iStock)
Dr. Marc Siegel, Fox News senior medical analyst, noted that previous research has shown that vitamin B3 decreases inflammation and bolsters immune function.
“Vitamins, including vitamin B vitamins (especially niacin), are underrecognized as immune boosters,” the doctor, who was not involved in the study, told Fox News Digital.
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Cautions and limitations
Despite the promising early results, the researchers urged caution.
“Glioblastoma is the most aggressive brain cancer in adults. Survival of patients with this condition hasn’t changed significantly for 20 years,” said lead study author Roldan Urgoiti, a clinical associate professor at the CSM, in the release. “Anything that may help should be explored, but it requires strict protocols and safety monitoring.”
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The study’s small sample size, short follow-up and lack of a randomized control group also posed limitations, the researchers acknowledged.
The researchers cautioned that high doses of vitamins can pose health risks, and that usage should be monitored by doctors. (iStock)
Larger, controlled trials are needed to confirm the findings, they said.
The researchers also cautioned that high doses of vitamins can pose health risks, and that usage should be monitored by doctors.
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Siegel agreed that niacin does have some side effects, including skin blushing.
“There probably will end up being a small impact here, so this is useful information, though clearly not a cure,” he added.
Heart attack deaths rising among young Americans
Fox News senior medical analyst Dr. Marc Siegel joins ‘America’s Newsroom’ to discuss a dramatic increase in fatal heart attacks among people under the age of 55 and how to keep the heart healthy.
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Scientists have developed a new therapy designed to repair cardiac damage after a heart attack.
The study, led by researchers at Columbia University and published in the journal Nature Biomedical Engineering, explored a two-step strategy that uses skeletal muscle to produce a healing molecule that activates when it reaches an injured heart.
Unlike many organs, the adult human heart has a limited ability to repair itself after a heart attack, the researchers noted.
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“The heart is one of the organs with the least ability to regenerate,” said Ke Cheng, a professor of biomedical engineering at Columbia and the study’s lead author, in a press release.
Dead muscle is typically replaced by stiff scar tissue, often leading to heart failure. However, newborns’ hearts can spontaneously regenerate during a brief window of time.
Scientists have developed a new therapy designed to repair cardiac damage after a heart attack. (iStock)
“The neonatal heart spontaneously produces more of this molecule after a heart attack,” Cheng said. “The adult can’t produce a sufficient amount, so we found a way to supplement this to the heart.”
“The whole idea is that we learn from nature.”
The secret to this treatment is a protein called ANP, which acts as a repair mechanism for the heart, according to the researchers. Normally, this protein is impossible to use as a drug because it dissolves in the blood within minutes, long before it can reach the heart.
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To solve this, researchers turned the body’s own skeletal muscles into a sort of factory to produce ANP, using a specialized RNA injection to give the arm or leg muscles a set of instructions.
These instructions tell the muscle to produce a “sleeping” version of the repair protein. This inactive version safely travels through the bloodstream until it hits the heart, according to the release.
Dead muscle is typically replaced by stiff scar tissue, often leading to heart failure, the researchers noted. (iStock)
Once there, it meets a specific enzyme that acts like a key, “waking up” the protein so it can begin repairing exactly where it’s needed.
In preclinical trials involving both small and large animals, a single injection into the limb reduced scarring and significantly improved heart function.
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Because the researchers used self-amplifying RNA, which replicates once it’s inside the body, the treatment continued to produce the healing protein for at least four weeks.
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The therapy remained effective even when administered a week after the initial injury, providing hope for patients who do not receive immediate treatment, the researchers also found.
The treatment continued to produce the healing protein for at least four weeks. (iStock)
“The patient doesn’t have to go to the hospital today and tomorrow,” Cheng said, noting that the method avoids the risks associated with injecting treatments directly into the heart muscle.
So far, the treatment has only been tested in animals, which poses a significant limitation to the study. Human hearts are much more complex, and clinical trials are needed to determine whether they react in the same way.
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Additionally, because the RNA remains active for several weeks, scientists need to ensure that producing this repair protein for an extended time doesn’t cause any unintended side effects in other parts of the body.
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Actress and singer Selena Gomez continues to be outspoken about mental health following her diagnosis with bipolar disorder.
The former Disney star announced her diagnosis in 2020 during an Instagram Live video call with fellow Disney Channel standout Miley Cyrus. Gomez has since described this discovery as a relief, although not an easy path.
In a recent episode of the “Friends Keep Secrets” podcast, Gomez – the co-founder of mental health publication Wondermind – shared details about her journey to diagnosis.
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Fellow musician and husband Benny Blanco asked his wife if she knew she was bipolar before being officially diagnosed.
“I knew something was wrong, but I think I was misdiagnosed,” she responded. “I think people were just assuming – and I would try multiple therapists.”
Actress and singer Selena Gomez continues to be outspoken about mental health following her diagnosis with bipolar disorder. (Michael Buckner/2026GG/Penske Media via Getty Images)
“It’s actually really hard when we’re talking about these things, and for me to go, ‘Go get a therapist.’ All of it is so … complicated.”
Gomez detailed how her diagnosis required talking to “multiple different people,” stressing the importance of not giving up.
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“I’m so grateful I went to four different rehabs because it all helped me understand it,” she said.
Blanco revealed that Gomez sometimes experiences a manic episode without recognizing it.
“She’ll start to realize she’s having it after it’s happening, and sometimes she doesn’t even remember when it’s happening,” he said.
“It’s such a delicate thing because … you’re not supposed to, technically, talk to the person about it while they’re deep in it.”
Blanco added that Gomez is “so hyper aware” of when she’s experiencing mania.
“I’m equally proud to say that I do have moments of mania,” she said. “I’m not ashamed at all, because I can catch them a bit quicker.”
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“It is helpful to have a partner who will understand … and meet you where you are,” the singer added.
Since her diagnosis, Gomez said she lives life more “freely.”
“The whole hypocrisy of shaming people for therapy, or people not understanding it, is that it’s just not for you,” she said. “But for me, it finally allowed me to go, ‘Oh, that’s why I handled things the way I [did]. That’s why all the other people were able to get over things quickly, and I wasn’t.’”
Blanco (left) revealed that Gomez sometimes experiences a manic episode without recognizing it. (Emma McIntyre)
Gomez added, “I’d act out of fear, I’d act out of love, I’d act out of passion, it was all inconsistent. It was crazy.”
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The actress encouraged others that no matter the diagnosis, “you are not defined by a term.”
“It’s just informative to seek and talk and listen to podcasts or listen to certain things that will help you get information,” she said. “I do believe there is a lot of hope.”
Signs of bipolar disorder
About 2.8% of adults in the U.S. have experienced bipolar in the last year, while 4.4% experience it during their lifetime, according to the National Institutes of Health.
Formerly called manic depression or “manic-depressive disorder,” bipolar disorder is characterized by dramatic shifts in mood, energy and activity levels, affecting the ability to carry out daily tasks.
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This can include emotional highs, referred to as mania or hypomania, and lows, known as depression, per Mayo Clinic.
Symptoms can differ depending on bipolar type.
“You are not defined by a term.”
Manic and hypomanic episodes typically include three or more of the following symptoms:
- Increased activity, energy or agitation
- Feeling too self-confident, or having a distorted sense of well-being
- Needing less sleep than usual
- Speaking quickly or being unusually talkative
- Having racing thoughts or jumping from one topic to the next
- Being easily distracted
- Making poor decisions
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Major depressive episodes include symptoms like feeling sad, empty and hopeless. (iStock)
Major depressive episodes typically include five or more of the following symptoms.
- Feeling depressed, sad, empty, hopeless or tearful
- Having a loss of interest or feeling no pleasure in most activities
- Losing weight when not dieting, or overeating and gaining weight
- Sleeping too much or too little
- Feeling restless or acting slower than usual
- Feeling very tired or losing energy
- Feeling worthless or guilty when unnecessary
- Struggling with thinking or concentrating, leading to an inability to make decisions
- Thinking about, planning or attempting suicide
Formerly called manic depression or “manic-depressive disorder,” bipolar disorder is characterized by dramatic shifts in mood, energy and activity levels. (iStock)
Seeking diagnosis
Mayo Clinic encourages anyone experiencing these symptoms to seek help from a professional.
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Diagnosis can be made through a physical exam and lab testing, as well as mental health assessments and tracking of moods, sleep patterns and other factors.
After diagnosis, Mayo Clinic recommends paying attention to warning signs to prevent episodes. Getting enough sleep, taking medications as directed, and abstaining from drugs and alcohol can also help.
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Fox News Digital reached out to Gomez’s representation and Wondermind for comment.
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