A Cancer Patient Got the First Successful Penis Transplant in US History

This story is part of a partnership between MedPage Today and VICE News.

A man who had his penis partially amputated due to cancer may have received a new lease on his love life after undergoing the first successful penis transplant in United States history, doctors in Massachusetts announced on Monday.

Thomas Manning, a 64-year-old from Halifax, Massachusetts, lost part of his manhood in 2012 after he was diagnosed with a rare case of penile cancer. He received a transplant penis from a deceased donor in a surgery that occurred during the first week of May. The procedure took 15 hours and involved a team of seven surgeons, six medical residents, and more than 30 other caregivers. Doctors said they are "cautiously optimistic" that he will regain sexual function.

"Today I begin a new chapter filled with personal hope and hope for others who have suffered genital injuries, particularly for our service members who put their lives on the line and suffer serious damage as a result," Manning wrote in a statement read at a press conference. "In sharing this success with all of you, it's my hope we can usher in a bright future for this type of transplantation.

"I want to thank the extraordinary medical team here at Mass General, who helped not only make this possible, but quite literally saved my life," he wrote. "I would also like to sincerely thank the family of the donor, whose wonderful gift has truly give me the second chance I never thought possible."

Penile cancer is "very uncommon," according to the American Cancer Society. So far in 2016, doctors have only diagnosed 2,030 new cases, and just 340 cases have been fatal. Patients like Manning can live without their genitalia, but the psychological impact of the injury "can be overwhelming," doctors in Massachusetts said.

"Many of these patients suffer in silence. And this patient has now found his voice," said urologist Dr. Dicken Ko, who, along with with plastic surgeon Dr. Curtis Cetrulo, Jr., led the team at Massachusetts General Hospital that performed Manning's transplant.

In December, Johns Hopkins University Medical Center announced plans to perform the nation's first penile transplant, and said that it would go to a military veteran injured in the line of duty. But this surgery took place at Massachusetts General Hospital, which began researching the possibility of doing a penile transplant shortly after its team, including Cetrulo, performed the first hand transplant in 2012.

Manning will likely need to be on immunosuppressant drugs for the rest of his life to prevent his body from rejecting the new appendage. Although he has no signs of rejection, infection, or bleeding, he still has a catheter. His doctors are optimistic that he will regain full function of the organ, and that it will regain sensation.

Donating a penis is not covered by checking the organ donation box on a driver's license, Carisa Cooney, a clinical research manager at the Johns Hopkins department of Reconstructive and plastic surgery, told VICE News in December. An organ procurement official must make an additional request, and this person can share the recipient's story to help persuade the families of a prospective donors.

In July 2014, the US enacted a new set of rules to make the transplant process go more smoothly in procedures known as vascularized composite allografts, or VCAs, which originally involved face and hand transplants. The surgeries, which were once unthinkable, have become increasingly common. The first face transplant was performed in 2005 in France, and there have now been 10 in the US.

According to the United Network for Organ Sharing (UNOS), which allocates organs for transplant, three hospitals are approved to perform "genitourinary" transplants, which include penis transplants: Massachusetts General Hospital, Johns Hopkins and Brigham and Women's Medical Center. The University of Maryland Medical System and Wake Forest Baptist Medical Center have also been approved to perform penile transplants.

Only one patient is currently on the waiting list to receive a penile transplant in the United States right now, UNOS said.

The world's first successful penis transplant was performed in South Africa in December 2014, and declared successful the following March. During a nine-hour procedure, doctors attached a donor organ to a young man whose penis had been amputated three years prior after a botched circumcision that led to a life-threatening infection. Nearly a year ago, doctors revealed that the 21-year-old man's girlfriend was pregnant.

The first recorded penile transplant attempt was performed in China in 2006, but the surgery was considered a failure. The abnormal swelling of the transplanted organ reportedly caused the patient and his wife psychological distress, prompting doctors to remove it.

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