First baby born after uterus transplanted from deceased donor

First baby born after uterus transplanted from deceased donor

While researchers in countries including Sweden and the U.S. have previously succeeded in transplanting wombs from living donors into women who have gone on to give birth, experts said the latest development was a significant advance.

Experts say the case study shows that uterus transplants from dead donors are feasible and may open access for all women with uterine infertility, without the need for live donors.

Dr. Richard Kennedy, President of the International Federation of Fertility Societies, who was not involved in the work, commented that the organization "welcomes this announcement, which is an anticipated evolution from live donors with clear advantages and the prospect of increasing supply for women with hitherto untreatable infertility". The mother in the Brazil case was born without a uterus as a result of Mayer-Rokitansky-Kuster-Hauser syndrome.

This woman had a single in-vitro fertilisation (IVF) cycle four months before the transplant took place, which resulted in eight fertilised eggs which were cryopreserved.

About six weeks later, she started having periods.

A womb transplant is performed by removing the womb from the donor and transplanting it into the recipient by connecting the two major veins and a series of arteries, ligaments and vaginal canals, according to The Lancet.

She received five immunosuppression drugs, as well as antimicrobials, anti-blood clotting treatment and aspirin while in hospital.

The first childbirth following uterine transplantation from living donors occurred in Sweden in September 2013 and were also published in The Lancet. She gave birth to a baby girl on December 15, 2017, by caesarean section.

The newborn weighed just over 2 kilograms. The mother and child managed to leave the hospital just three days after the birth, with a gloriously uneventful following few months. At the time of writing the study, the baby was 7 months old and growing normally.

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The case was proof-of-concept that deceased donor uterine transplantation was "a new option for women with uterine infertility" lead researcher and gynaecologist Dr Dani Ejzenberg said.

Future recipients undergoing similar transplants would have to be fit and healthy to avoid complications, they said.

An estimated one in 500 women have no wombs or abnormal wombs due to hysterectomies, inherited disease, malformation or infection. "It is also a source of hope for those patients who [do not have a uterus] or who have lost it unexpectedly and do not have a family member or close friend to donate the uterus".

It is not clear yet, for instance, whether transplants from live or deceased donors will end up being more successful in the long run, she says.

"I don't know that they're highlighted enough when we're celebrating these kind of breakthroughs", she said.

"And it wouldn't be a cheap procedure ..." Uterine transplants are considered "ephemeral", meaning they only stay in to allow the recipient to have children and are then removed.

Unlike most transplantation surgeries "this is not a matter of life and death but more to satisfy a woman's desire to carry a child", Professor Salamonsen said.

Still, women who do carry a baby using this technique face challenges, he added. The demonstrated success of a procedure involving a deceased donor, he says, may spare live donors from undergoing risky procedures, and make transplants possible for far more women.

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