Abstract
This paper aimed to describe the basic aspects of uterine transplant (UTx) research in humans, including preliminary experiences in rodents and domestic species. Studies in rats, domestic species, and non-human primates validated and optimized the UTx procedure in terms of its surgical aspects, immunosuppression, rejection diagnosis, peculiarities of pregnancy in immunosuppressed patients, and patients with special uterine conditions. In animal species, the first live birth from UTx was achieved in a syngeneic mouse model in 2003. Twenty-five UTx procedures have been performed in humans. The first two cases were unsuccessful, but established the need for rigorous research to improve success rates. As a result of a controlled clinical study under a strictly designed research protocol, nine subsequent UTx procedures have resulted in six healthy live births, the first of them in 2014. Further failed UTx procedures have been performed in China, Czech Republic, Brazil, Germany, and the United States, most of which using living donors. Albeit still an experimental procedure in, UTx is the first potential alternative for the treatment of absolute uterine factor infertility (AUFI).
Highlights
The clinical field of tissue transplantation includes uterine transplants (UTx)
Hysterectomy is indicated after parity mainly to avoid the risks secondary to long-term immunosuppression
Motherhood options traditionally offered to women with Absolute uterine factor infertility (AUFI) revolve around adoption or surrogacy
Summary
The clinical field of tissue transplantation includes uterine transplants (UTx). UTx has its peculiarities. Experiments in this animal model showed normal pregnancy and in utero development of pups in uteruses that had undergone cold ischemia for 24 hours prior to transplantation (El-Akouri et al, 2003). This type of anastomosis between uterine vessels can only be performed when the recipient undergoes a hysterectomy at the time of transplantation, which may be relevant to humans in the rare cases of AUFI caused by uterine adhesions or uterine malformations.
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