Uterus Transplantation: From a Deceased Donor or Living Donor?

Kisu, Iori; Banno, Kouji

doi:10.3390/jcm11164840

Cited by 8 publications

(3 citation statements)

References 25 publications

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“…As vantagens de um doador vivo incluem tempo suficiente para testes pré-operatórios, triagem, imagens do útero e vasos sanguíneos, enquanto as principais desvantagens são que a cirurgia do doador é invasiva, tem um longo tempo operatório e está sujeita a complicações (Kisu, 2022).…”

Section: Seleção De Doadoresunclassified

Transplante uterino: implicações reprodutivas, aplicabilidades clínicas e a experiência com nascidos vivos

Grespan,

Lopes,

Grespan

et al. 2024

CLCS

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Nos últimos anos, houve notáveis avanços no tratamento da infertilidade. No entanto, a infertilidade absoluta por fator uterino ainda é uma problemática sem solução definida, sendo o transplante de útero (TU) uma nova perspectiva a essa condição. Essa terapêutica é revolucionária do ponto de vista técnico, mas suscita debates sobre as naturezas éticas, legais e psicológicas envolvidas no procedimento. O impacto socioeconômico e cultural do TU também merece análise cuidadosa, especialmente em relação à acessibilidade e equidade no acesso a essa tecnologia inovadora. Esta revisão bibliográfica busca atualizar o conhecimento sobre o TU, resumindo estudos sobre critérios de seleção de doadoras e receptoras, procedimentos, possíveis complicações e aspectos materno-fetais. Apesar de algumas controvérsias em torno do procedimento, os resultados são promissores e representam uma opção inovadora para a concepção. A colaboração interdisciplinar entre médicos, cientistas, éticos, legisladores e membros da comunidade é essencial para garantir uma abordagem abrangente e responsável no avanço do transplante de útero como uma opção viável de tratamento para a infertilidade. A conscientização pública e o apoio financeiro para pesquisas nessa área são igualmente importantes para impulsionar o progresso e superar os desafios restantes.

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Section: Seleção De Doadoresunclassified

Transplante uterino: implicações reprodutivas, aplicabilidades clínicas e a experiência com nascidos vivos

Grespan,

Lopes,

Grespan

et al. 2024

CLCS

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“…Uterine transplantation differs from other forms of transplantation (solid organs or VCA) in many ways: (i) it gives women with absolute uterine factor infertility a chance to realize their wish for a biological child; (ii) the clinical outcome is not only relevant for the patient but also for the child conceived; (iii) transplantation is transitory and its endpoint is marked by graft hysterectomy; (iv) the surgical success rate is defined by a technically successful transplantation with a subsequent regular menstrual pattern potentially allowing for pregnancy and live birth of a child to round off surgical success ( Brännström et al, 2021 ); (v) even after successful uterus transplantation pregnancy may still fail; (vi) about two-thirds of donors are live donors due to disadvantages of deceased donation ( Kisu and Banno, 2022 ); (vii) the surgery is even more invasive and complicated for the live donor than for the recipient and for both patients there are high surgical complication rates ( Brännström et al, 2021 ); (viii) additional risks for live donors include possible familial pressure to donate and reduced quality of life due to hysterectomy and sexual dysfunction ( Kisu and Banno, 2022 ); and (ix) thus far, children born as a result of uterus transplantation were born prematurely at a high rate and with an associated high proportion of respiratory distress syndrome ( Brännström et al, 2021 ).…”

Section: Important Psychosocial Issues Identified By Recent Research ...mentioning

confidence: 99%

Psychosocial and bioethical challenges and developments for the future of vascularized composite allotransplantation: A scoping review and viewpoint of recent developments and clinical experiences in the field of vascularized composite allotransplantation

et al. 2022

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Vascularized Composite Allotransplantation (VCA) has evolved in recent years, encompassing hand, face, uterus, penile, and lower extremity transplantation. Accordingly, without centralized oversight by United States Organ Procurement and Transplantation Network (OPTN) or European Programs, centers have developed their own practices and procedures that likely vary, and accordingly, present different levels of rigor to the evaluation process, internationally. The importance of psychosocial factors in the selection process and treatment course has been widely recognized, and therefore, several approaches have been developed to standardize and guide care of VCA candidates and recipients. We propose to develop an international multidisciplinary platform for the exchange of expertise that includes clinical, patient, and research perspectives. Patient perspectives would derive from peer education and the assessment of patient-reported outcomes. To establish a foundation for such a platform, future research should review and combine current VCA protocols, to develop the ethical framework for a standardized psychosocial evaluation and follow-up of VCA candidates and recipients. This review presents a comprehensive overview of recent results in the field of VCA, developments in structural aspects of VCA, and provides viewpoints driven from clinical experience.

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“…Up to now, >80 human UTx operations have been performed globally, resulting in >40 live births. 5 Of the UTx, approximately two-thirds of the UTx procedures have been performed using uteri obtained from living donors, and the success rate (78%) is slightly higher than those obtained from deceased donors (64%). Twenty-four live births have now been reported in the media following UTx.…”

Section: Introductionmentioning

confidence: 99%

Transplantation of the Uterus in the Male Rat

et al. 2023

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Background. Uterus transplantation (UTx) is one of the potential methods to cure absolute uterine factor infertility of transgender. However, this mostly comes with many technological challenges. Methods. Left inguinal UTx was performed in 13 castrated male rats. End-to-end anastomosis of donor common iliac vessels to recipient femoral vessels was used for transsexual UTx. Sampling was performed on day 30 after transplantation. Grafts were used to analyze the histological changes. TUNEL assay was applied to stain the apoptotic cells. Immunological rejection was judged by flow cytometry. Results. Six uteri, 4 ovaries, and 4 upper vaginas were found at day 30 posttransplantation. Similar histological changes to proestrus, estrus, and diestrus of female rats were examined in the transplanted uteri. The histological changes of transplanted vaginas showed similarity to proestrus, estrus, and metestrus of the female rats. Follicles of different stages and corpus luteum with distinct morphological appearances were also observed. The TUNEL assay revealed a higher apoptosis of granulosa cells in transplanted ovaries compared with normal ovaries. Conclusions. A rat model of transsexual unilateral inguinal uterine transplantation in castrated rats was established, which will provide a reference for bilateral transsexual UTx in animals and genetically 46 XY individuals who wish to become real women through transsexual UTx.

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Uterus Transplantation: From a Deceased Donor or Living Donor?

Abstract: Uterus transplantation (UTx) is a new alternative to surrogacy or adaption for women with uterine factor infertility to have a child [...]

Cited by 8 publications

References 25 publications

Transplante uterino: implicações reprodutivas, aplicabilidades clínicas e a experiência com nascidos vivos

Transplante uterino: implicações reprodutivas, aplicabilidades clínicas e a experiência com nascidos vivos

Psychosocial and bioethical challenges and developments for the future of vascularized composite allotransplantation: A scoping review and viewpoint of recent developments and clinical experiences in the field of vascularized composite allotransplantation

Transplantation of the Uterus in the Male Rat

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