PD25-12 MONOZYGOTIC TWIN UTERUS TRANSPLANTATION

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery I1 Apr 2018PD25-12 MONOZYGOTIC TWIN UTERUS TRANSPLANTATION Miroslav Djordjevic, Milan Milenkovic, Pernilla Dahm-Kähler, Niclas Kvarnström, Stefan Tullius, Marta Bizic, Gradimir Korac, and Mats Brännström Miroslav DjordjevicMiroslav Djordjevic More articles by this author , Milan MilenkovicMilan Milenkovic More articles by this author , Pernilla Dahm-KählerPernilla Dahm-Kähler More articles by this author , Niclas KvarnströmNiclas Kvarnström More articles by this author , Stefan TulliusStefan Tullius More articles by this author , Marta BizicMarta Bizic More articles by this author , Gradimir KoracGradimir Korac More articles by this author , and Mats BrännströmMats Brännström More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1339AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Transplantation of the uterus is required in cases of absolute uterine factor infertility (AUFI), which are caused either because of uterus deficiency (congenital or after a hysterectomy) or existence of non-functional uterus. METHODS Uterus transplantation between two 37-year-old monozygotic twin sisters, was performed in March 2017, at University Children's Hospital. Donor sister had three pregnancies from which she gave birth to three children by vaginal delivery. In-vitro fertilization treatment of the recipient and her husband was performed before the surgery, from which 11 embryos were cryopreserved. The donor surgery lasted for 12 hours, while the recipient surgery lasted for 4.5 hours. The surgeries were performed by two teams parallel in two adjacent operative theatres. The anastomosis was created between uterine artery and external iliac artery as well as between uterine vein and external iliac vein on both sides. Adequate perfusion was confirmed by Doppler echosonography. RESULTS Both patients had uneventful surgeries. The uterus recipient was followed on a daily basis by Doppler echosonography during the hospital stay, and both patients were discharged after 7 days of hospitalization. Cervix biopsies were performed of 7th, 14th and 21st day after the surgery as well as regular gynecological examination with the bacterial culture from the cervix. The recipient patient did not have to take the immunosuppressive therapy as the donor was a monozygotic twin. Menstrual bleeding occurred 2 weeks after the uterus transplantation and embryo transfer was performed in September 2017 with no success and the second is planned three months after. CONCLUSIONS Uterus transplantation represents the only treatment in cases of AUFI, particularly since the surrogacy is not allowed in many countries and cultures. Though debates on ethical and moral issues concerning uterus transplantation are still present, it certainly represents hope for motherhood in women with absolute uterine factor infertility. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e551 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Miroslav Djordjevic More articles by this author Milan Milenkovic More articles by this author Pernilla Dahm-Kähler More articles by this author Niclas Kvarnström More articles by this author Stefan Tullius More articles by this author Marta Bizic More articles by this author Gradimir Korac More articles by this author Mats Brännström More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...