New Frontier: Role of the Radiologist in Uterine Transplantation

Feldman, Myra K.; Hunter, Sara A.; Perni, Uma; Liu, Peter; Quintini, Cristiano; Tzakis, Andreas G.; Flyckt, Rebecca

doi:10.1148/rg.2020190123

Cited by 6 publications

(4 citation statements)

References 28 publications

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“…22,24 Considering this, younger uterus donors would likely be advantageous to transplant outcomes where the vessel size of grafted uterine veins and arteries is substantially smaller than for liver or kidney. 25 Applying reduced age criteria in this study, to less than 45 years old, would reduce the availability of donors by half to ten per year. If the age criterion is reduced to younger than 35 years old, two-thirds of donors would have been ineligible, reducing the overall annual number to six or seven available uteri per year in NSW.…”

Section: Discussionmentioning

confidence: 88%

“…Each of these issues are associated with a greater chance of early graft failure or rejection 22,24 . Considering this, younger uterus donors would likely be advantageous to transplant outcomes where the vessel size of grafted uterine veins and arteries is substantially smaller than for liver or kidney 25 . Applying reduced age criteria in this study, to less than 45 years old, would reduce the availability of donors by half to ten per year.…”

Section: Discussionmentioning

confidence: 98%

“…1 Diagnostic imaging (pelvic magnetic resonance angiogram and computed tomography angiogram) has been used in Cleveland, USA, to evaluate the deceased donor's arterial and venous characteristics in uterus transplant and could be applied to screen older donors before exclusion. 25 A separate population we explored to expand donor numbers was the population of donation after circulatory death, rather than brain death. Once cardio-respiratory support is withdrawn in a donation following circulatory death, the time can vary before death is pronounced.…”

Section: Discussionmentioning

confidence: 99%

“…These reduced numbers may be offset by a concurrent living‐donation program with the advantage of a timed procedure that allows for a longer time to investigate the donor organ, and to date has been associated with greater successful outcomes 1 . Diagnostic imaging (pelvic magnetic resonance angiogram and computed tomography angiogram) has been used in Cleveland, USA, to evaluate the deceased donor's arterial and venous characteristics in uterus transplant and could be applied to screen older donors before exclusion 25 …”

Section: Discussionmentioning

confidence: 99%

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Deceased donor availability for uterus transplantation in Australia

Pittman

Abbott

Cavazzoni

et al. 2023

Aust NZ J Obst Gynaeco

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BackgroundUterus transplantation is an emerging treatment option for uterine factor infertility. Most uterus transplantation research programs use living donors, although this comes with considerable surgical and psychological risks and not all women desiring uterus transplantation will have an available living donor. A deceased donor program eliminates donor risks; however, the availability of deceased uterus donors is currently unknown in Australia.AimsTo establish the feasibility of a deceased donor uterus transplantation program in Australia and consider expanded inclusion criteria for this model.Materials and MethodsA retrospective review of the New South Wales (NSW) Organ and Tissue Donation Service database was undertaken to identify potential deceased uterus donors, with comparison to the broad deceased donor inclusion criteria from three international uterus transplantation trials including female, brain‐dead, multi‐organ donation, no major abdominal surgery, and <60 years of age.ResultsBetween January 1, 2018, and December 31, 2022, 648 deceased donors were available in NSW. Of these, 43% (279/648) were female and 67% of the women (187/279) were also multi‐organ donors. When the brain‐dead donor‐only and age criteria (<60 years) were applied, a total of 107 deceased donors met the available criteria for uterus transplantation, with an average of 21 deceased donors per year in NSW.ConclusionsThere appears to be adequate deceased donor organ availability to establish a deceased uterus transplantation program in NSW, Australia. Should interest in uterus transplantation increase, including criteria such as older and nulliparous donors could increase organ availability for a uterus transplantation program.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Deceased donor availability for uterus transplantation in Australia

Pittman

Abbott

Cavazzoni

et al. 2023

Aust NZ J Obst Gynaeco

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Uterus transplantation: state of the art in 2021

Richards

Farrell

Ricci

et al. 2021

J Assist Reprod Genet

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Purpose To provide a comprehensive review of uterus transplantation in 2021, including a discussion of pregnancy outcomes of all reported births to date, the donor and recipient selection process, the organ procurement and transplant surgeries, reported complications, postoperative monitoring, preimplantation preparation, and ethical considerations. Methods Literature review and expert commentary. Results Reports of thirty-one live births following uterus transplantation have been published from both living and deceased donors. The proper selection of donors and recipients is a labor-intensive process that requires advanced planning. A multidisciplinary team is critical. Reported complications in the recipient include thrombosis, infection, vaginal stricture, antenatal complications, and graft failure. Graft rejection is a common occurrence but rarely leads to graft removal. While most embryo transfers are successful, recurrent implantation failures in uterus transplant patients have been reported. Rates of preterm delivery are high but appear to be declining; more data, including long-term outcome data, is needed. Conclusions Uterus transplantation is an emerging therapy for absolute uterine factor infertility, a condition previously without direct treatment options. It is paramount that reproductive health care providers are familiar with the uterus transplantation process as more patients seek and receive this treatment.

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Imaging of Uterine Transplantation

Hunter¹,

Feldman²

2023

Radiologic Clinics of North America

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New Frontier: Role of the Radiologist in Uterine Transplantation

Cited by 6 publications

References 28 publications

Deceased donor availability for uterus transplantation in Australia

Deceased donor availability for uterus transplantation in Australia

Uterus transplantation: state of the art in 2021

Imaging of Uterine Transplantation

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