Penile Allotransplantation for Complex Genitourinary Reconstruction.

Area of Science:

• Regenerative Medicine
• Transplantation Surgery
• Urology

Background:

• Vascularized composite allotransplantation (VCA) enables reconstruction of complex functional structures.
• Penile transplantation is an emerging VCA treatment for severe penile tissue loss and disfigurement.
• Three human allogeneic penile transplantations have been reported.

Purpose of the Study:

• Review existing penile transplant cases.
• Outline indications for penile transplantation.
• Discuss preclinical models and immunosuppression strategies.

Main Methods:

• Comprehensive literature review from 1970-2016.
• Searched MEDLINE, PubMed, and Google using keywords: "penis transplantation," "penile rejection," "penile replantation," "penile tissue loss," and "penis vascularized composite allotransplantation."
• Selected relevant articles including original research, reviews, and press reports.

Main Results:

• Three allogeneic penile transplantations performed; one graft was removed after 14 days.
• One recipient achieved natural spontaneous erections and successful partner impregnation.
• All three patients demonstrated spontaneous urinary voiding through the transplanted urethra.

Conclusions:

• Penile transplantation is a complex procedure with significant ethical and psychosocial considerations.
• The procedure can restore urinary function and natural erections.
• Further preclinical research is essential to optimize penile transplantation and understand graft function under immunosuppression.