Man Receives First Penis Transplant in US

Thomas Manning after the successful surgery

A man whose penis was removed because of cancer has received the first penis transplant in the United States, at Massachusetts General Hospital in Boston.

Thomas Manning, 64, a bank courier from Halifax, Mass., underwent the 15-hour transplant operation by a team doctors on May 8 and 9. The organ came from a deceased donor.

“I want to go back to being who I was,” Mr. Manning said on Friday in an interview in his hospital room. Sitting up in a chair, happy to be out of bed for the first time since the operation, he said he felt well and had experienced hardly any pain.

“We’re cautiously optimistic,” said Dr. Curtis L. Cetrulo, a plastic and reconstructive surgeon and a leader of the surgical team. “It’s uncharted waters for us.”

The surgery is experimental, part of a research program with the ultimate goal of helping combat veterans with severe pelvic injuries, as well as cancer patients and accident victims.

If all goes as planned, normal urination should be possible for Mr. Manning within a few weeks, and sexual function in weeks to months, Dr. Cetrulo said.

Mr. Manning welcomed questions and said he wanted to speak out publicly to help dispel the shame and stigma associated with genital cancers and injuries, and to let other men know there was hope of having normal anatomy restored.

“Don’t hide behind a rock,” he said.

He said he was not quite ready to take a close look at his transplant.

He will have to take several anti-rejection drugs for the rest of his life. One of them, tacrolimus, seems to speed nerve regeneration and may help restore function to the transplant, Dr. Cetrulo said.

Another patient, his penis destroyed by burns in a car accident, will receive a transplant as soon as a matching donor becomes available, Dr. Cetrulo said.

Dr. Cetrulo estimated the cost at $50,000 to $75,000. Both hospitals are paying for the procedures, and the doctors are donating their time.

Worldwide, only two other penis transplants have been reported: a failed one in China in 2006 and a successful one in South Africa in 2014, in which the recipient later fathered a child.

Veterans are a major focus of transplant programs in the United States because suicide rates are exceptionally high in soldiers with severe damage to the genitals and urinary tract, Dr. Cetrulo said. “They’re 18- to 20-year-old guys, and they feel they have no hope of intimacy or a sexual life,” he said. “They can’t even go to the bathroom standing up.”

Given the psychological toll, he said, a penis transplant can be lifesaving.

The Massachusetts General team spent three years preparing for the penis transplants. The team did meticulous dissections in a cadaver lab to map out anatomy, and operated on five or six dead donors to practice removing the tissue needed for the transplants. Mr. Manning’s operation involved about a dozen surgeons and 30 other health care workers.

Dr. Dicken Ko, a team leader and the director of the hospital’s regional urology program, said the team had not planned a set number of transplants. Instead, he said, the hospital will evaluate candidates one at a time and decide whether to allow surgery. For now, he said, the transplants will be limited to cancer and trauma patients, and will not be offered to transgender people.

Dr. Dicken Ko (left) and Dr. Curtis L. Cetrulo,

leaders of the surgical team, at Massachusetts General Hospital

An accident at work in 2012 brought Mr. Manning to the hospital, and ultimately to the transplant team. Heavy equipment had fallen on him, causing severe injuries. The doctors treating him saw an abnormal growth on his penis that he had not noticed.

Mr. Manning was stunned that it had happened so fast. Dr. Cetrulo credits the New England Organ Bank, which asks families of some dying patients to consider organ donation. The organ bank said the donor’s family wished to remain anonymous but had extended a message to Mr. Manning saying they felt blessed and were delighted his recovery was going well.

Organ banks do not assume that families who donate internal organs like kidneys and livers will also be willing to give visible or intimate parts like a face, hands or a penis. Those requests are made separately. Several families have agreed to allow the penis to be removed, and none have declined, said Jill Stinebring, the organ bank’s regional director of organ donation services.

So far, Mr. Manning has had one serious complication. The day after his surgery, he began to hemorrhage and was rushed back to the operating room.

Since then, his recovery has been smoother, he said. He has no regrets. He looks forward to going back to work and hopes to eventually have a love life again.