First clinical uterus transplantation trial: a six-month report

Mats Brännström, Liza Johannesson, Pernilla Dahm-Kähler, Anders Enskog, Johan Mölne, Niclas Kvarnström, Cesar Diaz-Garcia, Ash Hanafy, Cecilia Lundmark, Janusz Marcickiewicz, Markus Gäbel, Klaus Groth, Randa Akouri, Saskia Eklind, Jan Holgersson, Andreas Tzakis, Michael Olausson, Mats Brännström, Liza Johannesson, Pernilla Dahm-Kähler, Anders Enskog, Johan Mölne, Niclas Kvarnström, Cesar Diaz-Garcia, Ash Hanafy, Cecilia Lundmark, Janusz Marcickiewicz, Markus Gäbel, Klaus Groth, Randa Akouri, Saskia Eklind, Jan Holgersson, Andreas Tzakis, Michael Olausson

Abstract

Objective: To report the 6-month results of the first clinical uterus transplantation (UTx) trial. This type of transplantation may become a treatment of absolute uterine-factor infertility (AUFI).

Design: Prospective observational study.

Setting: University hospital.

Patient(s): Nine AUFI women and their live uterine donors, the majority being mothers.

Intervention(s): Live-donor UTx and low-dose induction immunosuppression.

Main outcome measure(s): Data from preoperative investigations, surgery and follow-up for 6 months.

Result(s): Durations of donor and recipient surgery ranged from 10 to 13 hours and from 4 to 6 hours, respectively. No immediate perioperative complications occurred in any of the recipients. After 6 months, seven uteri remained viable with regular menses. Mild rejection episodes occurred in four of these patients. These rejection episodes were effectively reversed by corticosteroid boluses. The two graft losses were because of acute bilateral thrombotic uterine artery occlusions and persistent intrauterine infection.

Conclusion(s): The results demonstrate the feasibility of live-donor UTx with a low-dose immunosuppressive protocol.

Clinical trial registration number: NCT01844362.

Keywords: Infertility; human; transplantation; uterus.

Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Source: PubMed

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