Bladder transplantation is one of the rarest surgical procedures in the world. As of mid-2025, only one successful human bladder transplant has ever been performed on a living patient. The procedure remains deeply experimental, with no established track record, no standard protocol, and only a single clinical trial currently recruiting participants.
The First Human Bladder Transplant
The world’s first bladder transplant in a living patient took place on May 4, 2025, at Ronald Reagan UCLA Medical Center. A joint team from USC and UCLA performed a combined kidney and bladder transplant on a patient who had been on dialysis and unable to produce urine for seven years. The transplanted kidney began producing urine immediately, draining into the new bladder, and the patient did not need dialysis after surgery.
Before this, the only other attempt was in 2023, when surgeons performed a bladder autotransplantation (moving a patient’s own bladder) in a brain-dead donor as a proof-of-concept study. That procedure used robotic surgery and was never intended to benefit the patient directly. It served as a technical rehearsal, following years of animal studies in pigs and practice on cadavers.
Why Bladder Transplants Are So Rare
Several factors have kept this procedure out of mainstream surgery for decades. The bladder sits deep in the pelvis, surrounded by complex blood vessel networks that are difficult to access and reconnect. Surgeons face limited visibility in that area, and the overall procedural complexity is significantly higher than for many other organ transplants. The 2023 proof-of-concept case required robotic technology that most transplant centers don’t have readily available, and the surgical times were too long to be practical during a standard multi-organ donor retrieval.
There’s also a fundamental cost-benefit question. Any organ transplant requires the recipient to take immunosuppressive drugs for life, which carry real risks: increased vulnerability to infections, higher cancer risk, kidney damage, heart problems, and diabetes. For a kidney or liver transplant, those trade-offs are clearly worth it because the alternative is death or dialysis. For a bladder alone, the calculus is less clear. Existing alternatives like surgical bladder reconstruction, while imperfect, don’t require lifelong immune suppression. That’s why the 2025 transplant was performed as a combined kidney-and-bladder procedure: the patient already needed the immunosuppression for the kidney, so adding the bladder didn’t impose additional drug burden.
What Patients Currently Get Instead
When the bladder needs to be removed, typically because of bladder cancer, surgeons reconstruct a replacement from the patient’s own intestinal tissue. This is called a neobladder, and it has been the standard approach for decades. Bladder cancer is the world’s tenth most common cancer, with roughly 500,000 new cases diagnosed globally in 2018, so there is no shortage of patients who need bladder replacement.
Neobladders work, but they aren’t perfect. They lack the natural nerve connections of a real bladder, so patients often need to learn new techniques to empty them. The number of these procedures being performed worldwide has actually been declining, partly because fewer surgeons are getting enough practice to maintain their skills. Other options include urinary diversion, where urine is rerouted to an external bag. None of these alternatives fully replicate normal bladder function, which is what makes a true transplant appealing in theory.
For patients who already have a kidney transplant and an abnormal lower urinary tract, outcomes are reassuring. A study tracking 19 kidney transplant recipients with previously reconstructed or augmented bladders found 94.8% patient survival and 89.6% graft survival over a median follow-up of nearly four years. None experienced organ rejection, and their mental health and energy levels matched the general population. This suggests the urinary system can tolerate transplanted organs well, even when the bladder has been surgically altered.
Who Might Be Eligible
UCLA is running the only active clinical trial for bladder transplantation, a Phase 0 first-in-human study. The eligibility criteria are narrow. Candidates must be between 18 and 70, and they need to fall into one of two categories: people with severe bladder disease that has caused recurrent infections and kidney damage, or people with localized bladder cancer requiring bladder removal (with an appropriate cancer-free interval if previously treated).
Critically, the trial only accepts patients who also need a kidney transplant or who are already taking immunosuppressive drugs for a previous organ transplant. This restriction exists specifically to avoid putting someone on lifelong immune suppression solely for a bladder. Candidates must also be able to perform intermittent self-catheterization or have someone at home who can help, since the transplanted bladder may not empty on its own the way a natural one does. People with HIV, active hepatitis, blood clotting disorders, or significant artery disease are excluded.
The Immunosuppression Problem
The biggest barrier to making bladder transplants more common isn’t the surgery itself. It’s what comes after. Like other transplants of non-life-sustaining body parts (hands, faces, uterus), a bladder transplant requires the recipient to suppress their immune system indefinitely. The side effects of these drugs are well documented and cumulative over time.
Researchers at UCLA are actively studying whether it’s possible to wean bladder transplant recipients off immunosuppression eventually, using a technique that involves collecting and reintroducing the patient’s own stem cells to train the immune system to tolerate the donor organ. If that works, it would dramatically change the risk calculus and potentially open the procedure to a much wider group of patients. For now, though, it remains theoretical.
How This Could Change
Researchers describe combined kidney-and-bladder transplantation as “the next frontier in abdominal organ transplants.” The May 2025 case demonstrated that the procedure is technically feasible, and the early results are promising. But a single successful case is a long way from routine clinical use. The trial at UCLA will need to show consistent results across multiple patients before other transplant centers begin adopting the technique, and the surgical complexity means it will likely remain limited to a handful of specialized hospitals for years.
For now, if you or someone you know is living with severe bladder dysfunction alongside kidney failure, the UCLA trial represents the only path to a bladder transplant. For everyone else, reconstructive surgery and urinary diversion remain the standard options, imperfect but well established.