One uterus bridging three generations: first live birth after mother-to-daughter uterus transplantation

Brännström, Mats; Bokström, Hans; Dahm‐Kähler, Pernilla; Díaz-García, César; Ekberg, Jana; Enskog, Anders; Hagberg, Henrik; Johannesson, Liza; Kvarnström, Niclas; Mölne, Johan; Olausson, Michael; Olofsson, Jan I.; Rodriguez‐Wallberg, Kenny A.

doi:10.1016/j.fertnstert.2016.04.001

Cited by 146 publications

(86 citation statements)

References 19 publications

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“…One center has already achieved great clinical success with seven transplants 10 and four live births that were successfully reported at the time of writing 9,11.…”

Section: Introductionmentioning

confidence: 99%

Sheep Model for Uterine Transplantation: The Best Option Before Starting a Human Program

Andraus¹,

Ejzenberg²,

Santos³

et al. 2017

Clinics

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OBJECTIVE:This study reports the first four cases of a uterine transplant procedure conducted in sheep in Latin America. The aim of this study was to evaluate the success of uterine transplantation in sheep.METHOD:The study was conducted at Laboratory of Medical Investigation 37 (LIM 37) at the University of São Paulo School of Medicine. Four healthy mature ewes weighing 40-60 kg were used as both the donor and recipient for a transplant within the same animal (auto-transplant). Institutional guidelines for the care of experimental animals were followed.RESULTS:The first two cases of auto-transplant were performed to standardize the technique. After complete uterine mobilization and isolation of the blood supply, the unilateral vascular pedicle was sectioned and anastomosed on the external iliac vessels. After standardization, the protocol was implemented. Procurement surgery was performed without complications or bleeding. After isolation of uterine arteries and veins as well as full mobilization of the uterus, ligation of the distal portion of the internal iliac vessels was performed with subsequent division and end-to-side anastomosis of the external iliac vessels. After vaginal anastomosis, the final case presented with arterial thrombosis in the left uterine artery. The left uterine artery anastomosis was re-opened and flushed with saline solution to remove the clot from the artery lumen. Anastomosis was repeated with restoration of blood flow for a few minutes before another uterine artery thrombosis appeared on the same side. All four animals were alive after the surgical procedure and were euthanized after the experimental period.CONCLUSION:We describe the success of four uterine auto-transplants in sheep models.

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“…One center has already achieved great clinical success with seven transplants 10 and four live births that were successfully reported at the time of writing 9,11.…”

Section: Introductionmentioning

confidence: 99%

Sheep Model for Uterine Transplantation: The Best Option Before Starting a Human Program

Andraus¹,

Ejzenberg²,

Santos³

et al. 2017

Clinics

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show abstract

“…In that study, the uterus was preserved post-partum, and immunosuppressive therapy was continued to attempt a second gestation in certain patients. Furthermore, the birth of healthy babies from organ-transplanted women has confirmed the efficacy and safety of certain immunosuppressive therapy during gestation following uterus transplantation 13,18,23,24.…”

Section: Discussionmentioning

confidence: 90%

“…At discharge from the hospital, the baby weighed 2040 g 13. The two subsequent births reported occurred without complications 18.…”

Section: Methodsmentioning

confidence: 98%

Uterine transplantation: a systematic review

Ejzenberg¹,

Mendes²,

Haddad³

et al. 2016

Clinics

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Up to 15% of the reproductive population is infertile, and 3 to 5% of these cases are caused by uterine dysfunction. This abnormality generally leads women to consider surrogacy or adoption. Uterine transplantation, although still experimental, may be an option in these cases. This systematic review will outline the recommendations, surgical aspects, immunosuppressive drugs and reproductive aspects related to experimental uterine transplantation in women.

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“…The donor uterus can be harvested from a deceased or live donor and multiparous women with a live birth to miscarriage ration of [1 should be preferred [103]. Nine uterine transplant cases have been performed by Dr. Brännström and colleagues to date and 7 of the 9 women have become pregnant, resulting in 5 successful deliveries [105,106]. In the United States, two uterus transplant trials are currently under way, one at the Cleveland Clinic and one at the Baylor University Medical Center [106].…”

Section: Uterus Transplantationmentioning

confidence: 99%