Mass. General Performs First Penis Transplant in U.S.

BOSTON, MA - In a 15-hour procedure spanning two days and performed by a more than 50-member team, surgeons at Boston's Massachusetts General Hospital have completed the first penis transplant in the U.S.

Thomas Manning, a 64-year-old bank courier for Halifax, lost his penis to cancer in 2012 and was the recipient of the transplant. The organ came from a deceased donor.

Cancer patient receives nation's first penis transplant https://t.co/QtfiL6ZvoW #7News pic.twitter.com/lCoDtuCXkz

— 7News Boston WHDH (@7News) May 16, 2016

In a press conference Monday, MGH surgeons described the intense isolation and loss that comes with losing the penis, as a result of injury or illness.

"Ultimately, it's a loss of self-identity," said Dr. Dicken Ko, the team leader and director of MGH's regional urology program. "These devastating losses are endured by themselves alone, and often in silence."

Manning, who surgeons described as a "courageous patient," was one such person. Manning "coped very well with his diagnosis," but "felt the loss" after a partial penectomy, the result of a diagnosis of rare and potentially fatal penile cancer, said his physician, Dr. Adam Feldman. He volunteered for the transplant, Feldman said.

"He wants to be whole again, he wants to be... not in the shadows," said Curtis Cetrulo, who led Manning's surgical team. "That really echoes what a lot of patients with these injuries feel like. It's difficult to talk about."

Surgeons said Manning is doing well Monday, roughly one week since the surgery was completed. They remain "cautiously optimistic."

The surgery means there is potential for other special tissue transplants, such as ears or fingers, Ko said. It also has potential implications for transgender surgeries, although that is outside their initial scope, surgeons said.

In the short-term, the surgical team plans to restrict the treatment to cancer and trauma patients, ideally extended to wounded warriors, veterans who have suffered devastating injuries that "can leave them so despondent they would consider taking their own lives," Cetrulo said.

The goal was to reconstruct the organ and restore its urological and sexual functions, Ko said. They did not work to restore reproductive abilities, due to the attendant ethical questions.

Even given the initial success, Cetrulo said the surgery requires a lifelong commitment to taking immune system-suppressing drugs, and long-term monitoring for functionality over time.

"It's still early days. It's still early in his course," cautioned Cetrulo. "But we're hopeful that through this kind of experimental surgery, we have learned enough to make it safe and routine."

The donor's family shared a short statement Monday through the New England Organ Bank, saying they "feel blessed (Manning's) recovery is going well and are praying for his recovery to continue." The donation has been "uplifting for the family, as it is helping them get through this difficult time," according to the statement.

In the case of penile donation, a special permission from the family is required before moving forward. This donor in question saved "multiple lives," according to a spokesperson for the organ bank.

For his part, Manning is reportedly upbeat. In a statement read Monday by his personal physician, Manning said the MGH team "quite literally saved my life," offering "a second chance I never thought possible."

"Today, I begin a new chapter, full of personal hope and hope for others who have suffered genital injuries," he said.

This marks the world's third recorded penile transplant. The first was performed in late 2014 at South Africa's University of Stellenbosch, and a second took place in China in 2005. Both transplants were eventually removed, one due to complications from a previous circumcision, and the second because of associated psychological problems.

Cetrulo said another penile transplant is planned as soon as a matching donor becomes available, assisting a patient whose organ was destroyed by severe burns resulting from a car accident.

>> Photo by Robert Gray, Flickr/Creative Commons