Mats Brännström1, Liza Johannesson2, Pernilla Dahm-Kähler2, Anders Enskog3, Johan Mölne4, Niclas Kvarnström5, Cesar Diaz-Garcia6, Ash Hanafy7, Cecilia Lundmark2, Janusz Marcickiewicz2, Markus Gäbel5, Klaus Groth2, Randa Akouri2, Saskia Eklind2, Jan Holgersson8, Andreas Tzakis9, Michael Olausson5. 1. Department of Obstetrics and Gynecology, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden. Electronic address: mats.brannstrom@obgyn.gu.se. 2. Department of Obstetrics and Gynecology, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden. 3. Department of Anesthesiology and Intensive Care, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden. 4. Department of Clinical Pathology, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden. 5. Department of Transplantation, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden. 6. Department of Gynecology and Obstetrics, La Fe University Hospital, University of Valencia, Valencia, Spain. 7. Department of Obstetrics and Gynecology, Griffith University, Gold Coast, Southport, Queensland, Australia. 8. Department of Clinical Chemistry and Transfusion Medicine, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden. 9. Department of Surgery, Cleveland Clinic, Weston, Florida.
Abstract
OBJECTIVE: To report the 6-month results of the first clinical uterus transplantation (UTx) trial. This type of transplantation may become a treatment of absolute uterine-factor infertility (AUFI). DESIGN: Prospective observational study. SETTING: University hospital. PATIENT(S): Nine AUFI women and their live uterine donors, the majority being mothers. INTERVENTION(S): Live-donor UTx and low-dose induction immunosuppression. MAIN OUTCOME MEASURE(S): Data from preoperative investigations, surgery and follow-up for 6 months. RESULT(S): Durations of donor and recipient surgery ranged from 10 to 13 hours and from 4 to 6 hours, respectively. No immediate perioperative complications occurred in any of the recipients. After 6 months, seven uteri remained viable with regular menses. Mild rejection episodes occurred in four of these patients. These rejection episodes were effectively reversed by corticosteroid boluses. The two graft losses were because of acute bilateral thrombotic uterine artery occlusions and persistent intrauterine infection. CONCLUSION(S): The results demonstrate the feasibility of live-donor UTx with a low-dose immunosuppressive protocol. CLINICAL TRIAL REGISTRATION NUMBER: NCT01844362.
OBJECTIVE: To report the 6-month results of the first clinical uterus transplantation (UTx) trial. This type of transplantation may become a treatment of absolute uterine-factor infertility (AUFI). DESIGN: Prospective observational study. SETTING: University hospital. PATIENT(S): Nine AUFI women and their live uterine donors, the majority being mothers. INTERVENTION(S): Live-donorUTx and low-dose induction immunosuppression. MAIN OUTCOME MEASURE(S): Data from preoperative investigations, surgery and follow-up for 6 months. RESULT(S): Durations of donor and recipient surgery ranged from 10 to 13 hours and from 4 to 6 hours, respectively. No immediate perioperative complications occurred in any of the recipients. After 6 months, seven uteri remained viable with regular menses. Mild rejection episodes occurred in four of these patients. These rejection episodes were effectively reversed by corticosteroid boluses. The two graft losses were because of acute bilateral thrombotic uterine artery occlusions and persistent intrauterine infection. CONCLUSION(S): The results demonstrate the feasibility of live-donorUTx with a low-dose immunosuppressive protocol. CLINICAL TRIAL REGISTRATION NUMBER: NCT01844362.
Authors: Sana M Salih; Samet Albayrak; Songwon Seo; Sarah L Stewart; Kristen Bradley; David M Kushner Journal: J Reprod Med Date: 2015 Jul-Aug Impact factor: 0.142