Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-25T01:34:53.780Z Has data issue: false hasContentIssue false

Chapter 34 - Uterus Transplantation

Clinical Practice

from Section 9 - New Research and Technologies

Published online by Cambridge University Press:  27 March 2021

By
Mats Brännström ,
Jana EJ Pittman  and
Pernilla Dahm-Kähler
Edited by
Jacques Donnez  and
S. Samuel Kim
Jacques Donnez
Affiliation:
Catholic University of Louvain, Brussels
S. Samuel Kim
Affiliation:
University of Kansas School of Medicine
Get access

Summary

Uterus transplantation (UTx) has now repeatedly shown that women with absolute uterine factor infertility (AUFI) can achieve both genetic and gestational motherhood [1–3]. Along with enabling the woman to experience pregnancy, UTx eliminates the issues around surrogacy, where legalities greatly vary between countries. In comparison to most other types of transplants, UTx can utilize both deceased donor (DD) and live donor (LD) grafts. It is also currently the only transient transplant to remain in situ for a short period of the lifetime of the recipient, thus greatly reducing the risk of the well-described long-term immunosuppressive side effects, such as nephrotoxicity.

Type
Chapter
Information
Fertility Preservation
Principles and Practice
 , pp. 394 - 403
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Brannstrom, M, Johannesson, L, Bokstrom, H et al. Livebirth after uterus transplantation. Lancet, 2015;385:607–616.Google Scholar
Brannstrom, M, Bokstrom, H, Dahm-Kahler, P et al. One uterus bridging three generations: first live birth after mother-to-daughter uterus transplantation. Fertil Steril, 2016;106(2):261–266.Google Scholar
Testa, G, McKenna, GJ, Gunby, RT Jr. et al. First live birth after uterus transplantation in the United States. Am J Transplant, 2018;18:1270–1274.Google Scholar
Sieunarine, K, Zakaria, FB, Boyle, DC et al. Possibilities for fertility restoration: a new surgical technique. Int Surg, 2005;90:249–256.Google Scholar
Oppelt, P, Renner, SP, Kellermann, A et al. Clinical aspects of Mayer-Rokitansky-Kuester-Hauser syndrome: recommendations for clinical diagnosis and staging. Hum Reprod, 2006;21:792–797.Google Scholar
Oppelt, PG, Lermann, J, Strick, R et al. Malformations in a cohort of 284 women with Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH). Reprod Biol Endocrinol, 2012;10:57.Google Scholar
Brannstrom, M, Diaz-Garcia, C, Johannesson, L et al. Livebirth after uterus transplantation – Authors’ reply. Lancet, 2015;385:2352–2353.Google Scholar
Chan, YY, Jayaprakasan, K, Tan, A et al. Reproductive outcomes in women with congenital uterine anomalies: a systematic review. Ultrasound Obstet Gynecol, 2011;38:371–382.Google Scholar
Fernandez, H, Al-Najjar, F, Chauveaud-Lambling, A et al. Fertility after treatment of Asherman’s syndrome stage 3 and 4. J Minim Invasive Gynecol, 2006;13:398–402.Google Scholar
Brannstrom, M, Diaz-Garcia, C, Hanafy, A et al. Uterus transplantation: animal research and human possibilities. Fertil Steril, 2012;97:1269–1276.Google Scholar
Moore, FD. Ethical problems special to surgery: surgical teaching, surgical innovation, and the surgeon in managed care. Arch Surg, 2000;135:14–16.Google Scholar
McCulloch, P, Altman, DG, Campbell, WB et al. No surgical innovation without evaluation: the IDEAL recommendations. Lancet, 2009;374:1105–1112.Google Scholar
Racho El-Akouri, R, Kurlberg, G, Dindelegan, G et al. Heterotopic uterine transplantation by vascular anastomosis in the mouse. J Endocrinol, 2002;174:157–166.Google Scholar
Racho El-Akouri, R, Kurlberg, G, Brannstrom, M. Successful uterine transplantation in the mouse: pregnancy and post-natal development of offspring. Hum Reprod, 2003;18:2018–2023.Google Scholar
Racho El-Akouri, R, Wranning, CA, Molne, J et al. Pregnancy in transplanted mouse uterus after long-term cold ischaemic preservation. Hum Reprod, 2003;18:2024–2030.Google Scholar
Wranning, CA, Akhi, SN, Diaz-Garcia, C, Brannstrom, M. Pregnancy after syngeneic uterus transplantation and spontaneous mating in the rat. Hum Reprod, 2011;26:553–558.CrossRefGoogle ScholarPubMed
Diaz-Garcia, C, Akhi, SN, Wallin, A et al. First report on fertility after allogeneic uterus transplantation. Acta Obstet Gynecol Scand, 2010;89:1491–1494.Google Scholar
Diaz-Garcia, C, Johannesson, L, Shao, R et al. Pregnancy after allogeneic uterus transplantation in the rat: perinatal outcome and growth trajectory. Fertil Steril, 2014;102:1545–1552 e1541.Google Scholar
Wranning, CA, Marcickiewicz, J, Enskog, A et al. Fertility after autologous ovine uterine-tubal-ovarian transplantation by vascular anastomosis to the external iliac vessels. Hum Reprod, 2010;25:1973–1979.Google Scholar
Ramirez, ER, Ramirez Nessetti, DK, Nessetti, MB et al. Pregnancy and outcome of uterine allotransplantation and assisted reproduction in sheep. J Minim Invasive Gynecol, 2011;18:238–245.CrossRefGoogle ScholarPubMed
Mihara, M, Kisu, I, Hara, H et al. Uterine autotransplantation in cynomolgus macaques: the first case of pregnancy and delivery. Hum Reprod, 2012;27:2332–2340.Google Scholar
Fageeh, W, Raffa, H, Jabbad, H, Marzouki, A. Transplantation of the human uterus. Int J Gynaecol Obstet, 2002;76:245–251.Google Scholar
Jarvholm, S, Johannesson, L, Brannstrom, M. Psychological aspects in pre-transplantation assessments of patients prior to entering the first uterus transplantation trial. Acta Obstet Gynecol Scand, 2015;94:1035–1038.Google Scholar
Brannstrom, M, Johannesson, L, Dahm-Kahler, P et al. First clinical uterus transplantation trial: a six-month report. Fertil Steril, 2014;101:1228–1236.Google Scholar
Jarvholm, S, Johannesson, L, Clarke, A, Brannstrom, M. Uterus transplantation trial: Psychological evaluation of recipients and partners during the post-transplantation year. Fertil Steril, 2015;104:1010–1015.CrossRefGoogle ScholarPubMed
Kvarnstrom, N, Jarvholm, S, Johannesson, L et al. Live donors of the initial observational study of uterus transplantation-psychological and medical follow-up until 1 year after surgery in the 9 cases. Transplantation, 2017;101:664–670.Google Scholar
Blume, C, Pischke, S, von Versen-Hoynck, F et al. Pregnancies in liver and kidney transplant recipients: a review of the current literature and recommendation. Best Pract Res Clin Obstet Gynaecol, 2014;28:1123–1136.Google Scholar
Molne, J, Broecker, V, Ekberg, J et al. Monitoring of human uterus transplantation with cervical biopsies: a provisional scoring system for rejection. Am J Transplant, 2017;17:1628–1636.Google Scholar
Brannstrom, M, Bokstrom, H, Dahm-Kahler, P et al. One uterus bridging three generations: first live birth after mother-to-daughter uterus transplantation. Fertil Steril, 2016;106:261–266.CrossRefGoogle ScholarPubMed
Wei, L, Xue, T, Tao, KS et al. Modified human uterus transplantation using ovarian veins for venous drainage: the first report of surgically successful robotic-assisted uterus procurement and follow-up for 12 months. Fertil Steril, 2017;108:346–356 e341.CrossRefGoogle ScholarPubMed
Shuster, LT, Gostout, BS, Grossardt, BR, Rocca, WA. Prophylactic oophorectomy in premenopausal women and long-term health. Menopause Int, 2008;14:111–116.Google Scholar
Chmel, R, Novackova, M, Janousek, L et al. Revaluation and lessons learned from the first nine cases of a Czech uterus transplantation trial: four deceased donor and five living donor uterus transplantations. Am J Transplant, 2019;19(3):855–864.Google Scholar
Brucker, SY, Brannstrom, M, Taran, FA et al. Selecting living donors for uterus transplantation: lessons learned from two transplantations resulting in menstrual functionality and another attempt, aborted after organ retrieval. Arch Gynecol Obstet, 2018;297(3):675–684.Google Scholar
Testa, G, Koon, EC, Johannesson, L et al. Living donor uterus transplantation: a single center’s observations and lessons learned from early setbacks to technical success. Am J Transplant, 2017;17:2901–2910.Google Scholar
Puntambekar, S, Telang, M, Kulkarni, P et al. Laparoscopic-assisted uterus retrieval from live organ donors for uterine transplant: our experience of two patients. J Minim Invasive Gynecol, 2018;25:622–631.Google Scholar
Ozkan, O, Akar, ME, Ozkan, O et al. Preliminary results of the first human uterus transplantation from a multiorgan donor. Fertil Steril, 2013;99:470–476.Google Scholar
Flyckt, RL, Farrell, RM, Perni, UC et al. Deceased donor uterine transplantation: innovation and adaptation. Obstet Gynecol, 2016;128:837–842.Google Scholar
Ejzenberg, D, Andraus, W, Baratelli Carelli, Mendes LR et al. Livebirth after uterus transplantation from a deceased donor in a recipient with uterine infertility. Lancet, 2019;392:2697–2704.Google Scholar
Miravet-Valenciano, JA, Rincon-Bertolin, A, Vilella, F, Simon, C. Understanding and improving endometrial receptivity. Curr Opin Obstet Gynecol, 2015;27:187–192.Google Scholar
Wranning, CA, Molne, J, El-Akouri, RR et al. Short-term ischaemic storage of human uterine myometrium–basic studies towards uterine transplantation. Hum Reprod, 2005;20:2736–2744.Google Scholar
Tricard, J, Ponsonnard, S, Tholance, Y et al. Uterus tolerance to extended cold ischemic storage after auto-transplantation in ewes. Eur J Obstet Gynecol Reprod Biol, 2017;214:162–167.Google Scholar
Erman Akar, M, Ozkan, O, Aydinuraz, B et al. Clinical pregnancy after uterus transplantation. Fertil Steril, 2013;100:1358–1363.Google Scholar
Johannesson, L, Enskog, A, Molne, J et al. Preclinical report on allogeneic uterus transplantation in non-human primates. Hum Reprod, 2013;28:189–198.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×