[Comment] Kidney–bladder transplantation: redefining surgical options for patients with concurrent bladder and kidney disease

Kidney–bladder transplantation: redefining surgical options for patients with concurrent bladder and kidney disease Affiliations & Notes Division of Transplant Surgery, Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ 85054, USA Article Info Publication History: Published June 23, 2026 DOI: 10.1016/S0140-6736(26)01025-1 External LinkAlso available on ScienceDirect External Link Copyright: © 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies. Linked Articles - Combined bladder–kidney transplantation: first-in-human feasibility trialThe LancetJune 23, 2026 Download started OkRestoring patients to fitness has long been central to organ transplantation. Thomas Starzl (1926–2017), widely recognised as the founder of modern transplantation, pioneered groundbreaking surgeries that offered patients with end-stage liver and kidney disease a renewed sense of wellbeing. In his memoir, Starzl referred to the transformative physical and mental changes brought about by a new organ.1 Although kidney transplantation can restore function and substantially improve quality of life for individuals with end-stage kidney disease, its benefits remain limited for patients who face both terminal bladder disease and kidney failure. In these patients, the changes brought about through kidney transplantation alone do not fully address the complex challenges these patients encounter. Although reconstructive bladder techniques are available, none can fully replicate the function of a healthy native bladder. Patients undergoing reconstructive bladder surgery must adjust to changes in urinary control, body image, and daily routines. Additionally, they face an increased risk of infection, which can have a negative effect on renal allograft survival. References 1. Starzl, T The puzzle people: memoirs of a transplant surgeon University of Pittsburgh Press, 1992 2. Dubernard, JM ∙ Owen, E ∙ Herzberg, G ∙ et al. Human hand allograft: report on first 6 months Lancet. 1999; 353:1315-1320 3. Nassiri, N ∙ Cacciamani, G ∙ Gill, IS Robotic bladder autotransplantation: preclinical studies in preparation for first-in-human bladder transplant J Urol. 2023; 210:600-610 4. Nassiri, N ∙ Gill, IS Combined bladder–kidney transplantation: first-in-human feasibility study Lancet. 2026; published online June 23. https://doi.org/10.1016/S0140-6736(26)00718-X 5. Wang, J ∙ Wu, J ∙ Moris, D ∙ et al. Introducing a novel experimental model of bladder transplantation in mice Am J Transplant. 2020; 20:3558-3566 6. Gargollo, PC ∙ Ahmed, ME ∙ Prieto, M ∙ et al. Feasibility study of vascularized composite urinary bladder allograft transplantation in a cadaver model J Urol. 2021; 206:115-123 7. Taber, DJ ∙ Gordon, EJ ∙ Myaskovsky, L ∙ et al. Therapeutic needs in solid organ transplant recipients: The American Society of Transplantation patient survey Am J Transplant. 2025; 25:2565-2577