When we first heard of hand transplants, it raised the question of how organ transplants could be justified when they aren't necessary to save a patient's life. We've come a long way since then, with limb and face transplants to improve the quality of life. When the first penis transplants were done, doctors knew that such experimental surgery would be an important achievement in caring for those wounded in war. And in March, the first American veteran received a penis transplant during a 14-hour operation at Johns Hopkins Hospital in Baltimore. The surgery was successful, and the penis is expected to achieve normal function within a few months. Researchers a the hospital developed a new technique to facilitate such reconstruction.
One of the challenges from this type of injury is that transplants typically require patients to take strong anti-rejection drugs for the rest of their lives. Those drugs pose a risk, which must be balanced against the benefit of surgery that is designed to improve quality of life but is not essential to health.
To address that, doctors at Hopkins have developed a method to minimize the drugs required for these patients. That involves infusing some blood cells from the donor, to prime the recipient's immune system to recognize the foreign tissue as "self." Doctors at Hopkins say they can then treat the patient with a single anti-rejection drug rather than the usual cocktail of three.
Unlike previous penis transplants, this surgery included the scrotum and some tissue from the lower abdomen, in order to reconstruct a large wound. The patient was injured by an improvised explosive device. He also lost his legs below the knee as a result of the IED attack.