Uterus transplantation

Last updated

A uterine transplant is a surgical procedure whereby a healthy uterus is transplanted into an organism of which the uterus is absent or diseased. As part of normal mammalian sexual reproduction, a diseased or absent uterus does not allow normal embryonic implantation, effectively rendering the female infertile. This phenomenon is known as absolute uterine factor infertility (AUFI). Uterine transplant is a potential treatment for this form of infertility.

Contents

History

Studies

In 1896, Emil Knauer, a 29-year-old Austrian working in one of Vienna's gynecological clinics, published the first study of ovarian autotransplantation documenting normal function in a rabbit. This led to the investigation of uterine transplantation in 1918. [1] [2] In 1964 and 1966, Eraslan, Hamernik and Hardy, at the University of Mississippi Medical Center in Jackson, Mississippi, were the first to perform an animal (dog) autotransplantation of the uterus and subsequently deliver a pregnancy from that uterus. [3] In 2010 Diaz-Garcia and co-workers, at Department of Obstetrics and Gynecology, University of Gothenburg in Sweden, demonstrated the world's first successful allogenic uterus transplantation, in a rat, with healthy offspring. [4]

As of 2023, more than 100 womb transplants have taken place, with around 50 babies having been born worldwide. [5] [6]

Notable cases

Germany

Except perhaps in rare cases of intersex individuals, transgender women are born with a male reproductive system. While sex reassignment surgery can create a vagina for these women, the option of a uterus is unavailable to them, meaning they cannot carry a pregnancy and would need to take other routes to parenthood, whether it be a more traditional approach involving coitus or an alternative one such as adoption, egg donation, or a gestational carrier. Nonetheless, at least one uterine transplant for a trans woman occurred, for the Danish artist Lili Elbe (1882–1931). [7] Hoping to have children with her fiancée, she underwent a uterine transplant in 1931, in conjunction with vaginoplasty, in Germany at the age of 48. However, she developed a postsurgical infection and died from cardiac arrest just three months later. [8]

Saudi Arabia

The first modern day attempt at a uterine transplant occurred in 2000, in Saudi Arabia. [9] Wafa Fageeh [9] transplanted a uterus, taken from a 46-year-old patient, into a 26-year-old patient whose uterus had been damaged by hemorrhaging following childbirth. [10] Because the patient ultimately needed for the uterus to be removed after just 99 days, due to necrosis, whether or not the case is considered successful is disputed, but the uterus did function for a time, with the patient experiencing two menstrual cycles. [9] Members of the medical community have expressed concerns over the ethics of the procedure. [11]

Turkey

The first incidence of a uterine transplant involving a deceased donor occurred in Turkey on 9 August 2011; the surgery, performed by Ömer Özkan and Munire Erman Akar, at the Akdeniz University Hospital in Antalya, on Derya Sert, a 21-year-old patient who'd been born without a uterus. [12] [13] [14] [15] [16] [17] In this case, the patient enjoyed long-term success with the transplanted uterus, experiencing periods and, two years post-surgery, pregnancy. [18] [19] [20] During that pregnancy, Sert underwent an abortion in her first trimester, after her doctor was unable to detect a fetal heartbeat, but this is a common complication and may not have been related to the transplant. [21] Following another pregnancy that was initiated with in vitro fertilisation and sustained for 28 weeks, the patient finally delivered a baby on June 4, 2020. [22]

Sweden

In Sweden in 2012, the first mother-to-daughter [23] uterine transplant was done by Swedish doctors at Sahlgrenska University Hospital at Gothenburg University led by Mats Brännström. [23] [24] [25]

In October 2014, it was announced that, for the first time, a healthy baby had been born to a uterine transplant recipient, at an undisclosed location in Sweden. The British medical journal The Lancet reported that the baby boy had been born in September, weighing 1.8 kg (3.9 lb) and that the father had said his son was "amazing". The baby had been delivered prematurely at about 32 weeks, by cesarean section, after the mother had developed pre-eclampsia. The Swedish woman, aged 36, had received a uterus in 2013, from a live 61-year-old donor, in an operation led by Brännström, Professor of Obstetrics and Gynaecology at the University of Gothenburg. [26] [27] The woman had healthy ovaries but was born without a uterus, a condition that affects about one in 4,500 women. The procedure used an embryo from a laboratory, created using the woman's ovum and her husband's sperm, which was then implanted into the transplanted uterus. The uterus may have been damaged in the course of the caesarian delivery and it may or may not be suitable for future pregnancies. A regimen of triple immuno-suppression was used with tacrolimus, azathioprine, and corticosteroids. Three mild rejection episodes occurred, one during the pregnancy, but were all successfully suppressed with medication. Some other women were also reported to be pregnant at that time using transplanted uteri. [28]

United States

The first uterine transplant performed in the United States took place on 24 February 2016 at the Cleveland Clinic. [29] The team was led by Dr Andreas Tzakis. The transplant failed due to an undisclosed complication on 8 March, and the uterus was removed. [30] In April, they reported a yeast infection had spread to one of the arteries the surgeons had connected to provide blood flow to the transplanted uterus, which damaged the artery and caused blood clots to form. [31]

In November 2017, the first baby was born after a uterus transplantation in the US. [32] The birth occurred at Baylor University Medical Center in Dallas, Texas, by Drs Liza Johannesson and Giuliano Testa, after a uterus donation from a non-directed living donor. [33] The first baby born after a deceased donor uterus transplant in the US was at the Cleveland Clinic in June 2019. [34]

India

The first uterine transplant performed in India took place on 18 May 2017 at the Galaxy Care Hospital in Pune, Maharashtra. The 26-year-old patient had been born without a uterus, and received her mother's womb in the transplant. [35] [36] India's first uterine transplant baby, weighing 1.45 kg, was delivered through a Caesarean section [37] at Galaxy Care Hospital in Pune on Thursday. [38] The surgery was performed by a team of doctors at Pune's Galaxy Care Hospital and led by the hospital's medical director, Shailesh Puntambekar. [39]

Brazil

The first uterine transplant performed in Brazil took place on 2016 at the Hospital das Clínicas da USP in São Paulo. The 32-year-old patient had Mayer-Rokitansky-Küster-Hauser Syndrome, and therefore born without an uterus, and received a deceased donor's womb in the transplant. [35] Brazil's first uterine transplant baby was delivered through a Caesarean section [37] at Hospital das Clínicas da USP in December 2017. The surgery was performed by a team of doctors at Hospital das Clínicas da USP and led by Dani Ejzenberg, the head of the Human Reproductive Center at the hospital. Results of this procedure, the first to be performed in Latin America, were published in the medical journal The Lancet, in December 2018. [39]

United Kingdom

On August 23, 2023, doctors at the Churchill Hospital Oxford in the U.K. conducted the country's first uterus transplant. They removed the uterus from a 40-year-old woman and transplanted it to her 34-year-old sister, who had a rare condition that affected her ability to reproduce. [40] A team of experts performed the surgery for 17 hours in total. [41] Prof Richard Smith, a gynaecological surgeon who led the organ retrieval team, has spent 25 years researching womb transplantation, said that the surgery was a "massive success". [42]

Australia

On 15 December 2023, the first baby (male) was born in Australia to a mother who received a transplanted uterus. Kristy Bryant received the uterus in January 2023 at the Royal Hospital for Women in Sydney, and fell pregnant within three months through embryo implantation. The donor was her mother, Michelle. [43]

Current status

The transplant is intended to be temporary – recipients will have to undergo a hysterectomy after one or two successful pregnancies. This is done to avoid the need to take immunosuppressive drugs for life with a consequent increased risk of infection. [44]

The procedure remains the last resort: it is a relatively new and somewhat experimental procedure, performed only by certain specialist surgeons in select centres, it is expensive and unlikely to be covered by insurance, and it involves risk of infection and organ rejection. Some ethics specialists consider the risks to a live donor too great, and some find the entire procedure ethically questionable, especially since the transplant is not a life-saving procedure. [45] [46] [47]

Description

Procedures

Uterine transplantation starts with the uterus retrieval surgery on the donor. Working techniques for this exist for animals, including primates and more recently humans. [48] [49] [50] [51] [52] [53] The recovered uterus may need to be stored, for example for transportation to the location of the recipient. Studies on cold-ischemia reperfusion indicate an ischemic tolerance of more than 24 hours. [49]

The recipient has to look at potentially three major surgeries. First of all, there is the transplantation surgery. If a pregnancy is established and carried to viability a cesarean section is performed. As the recipient is treated with immuno-suppressive therapy, eventually, after completion of childbearing, a hysterectomy needs to be done so that the immuno-suppressive therapy can be terminated.[ citation needed ]

Ethics

Montreal criteria

Aside from considerations of costs, uterine transplantation involves complex ethical issues. The principle of autonomy supports the procedure, while the principle of non-maleficence argues against it. In regard to the principles of beneficence and justice the procedure appears equivocal. [11] To address this dilemma the "Montreal Criteria for the Ethical Feasibility of Uterine Transplantation" were developed at McGill University and published in Transplant International in 2012. [11] The Montreal Criteria are a set of criteria deemed to be required for the ethical execution of the uterine transplant in humans. These findings were presented at the International Federation of Gynecology and Obstetrics' 20th World Congress in Rome in October 2012. [54] In 2013 an update to "The Montreal Criteria for the Ethical Feasibility of Uterine Transplantation" was published in Fertility and Sterility and has been proposed as the international standard for the ethical execution of the procedure. [55]

The criteria set conditions for the recipient, the donor, and the health care team, specifically:

  1. The recipient is a genetic female, with the ability to consent, with no medical contraindications to transplantation, has uterine disease that has failed other therapy, and has "a personal or legal contraindication" to other options (surrogacy, adoption). The recipient needs to be considered suitable for motherhood, deemed to be psychologically fit on evaluation, is likely to be compliant with treatment and the medical team, and understands the risks of the procedure. In 2021, a revision to the Montreal Criteria was published in Bioethics with an ethical framework for consideration of genetic XY individuals to be eligible for uterine transplants. [56]
  2. The donor is a female of reproductive age with no contraindication to the procedure who has concluded her childbearing or consented donating her uterus after her death. There is no coercion and the donor is responsible and capable of making informed decisions.
  3. The health care team belongs to an institution that meets Moore's third criterion [57] regarding institutional stability and has provided informed consent to both parties. There is no conflict of interests, and anonymity can be protected unless recipient or donor waive this right.

See also

Related Research Articles

Dilationand curettage (D&C) refers to the dilation of the cervix and surgical removal of part of the lining of the uterus or contents of the uterus by scraping and scooping (curettage). It is a gynecologic procedure used for diagnostic and therapeutic purposes, and is the most commonly used method for first-trimester miscarriage or abortion.

<span class="mw-page-title-main">Uterus</span> Female sex organ in mammals

The uterus or womb is the organ in the reproductive system of most female mammals, including humans, that accommodates the embryonic and fetal development of one or more embryos until birth. The uterus is a hormone-responsive sex organ that contains glands in its lining that secrete uterine milk for embryonic nourishment.

Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical field.

<span class="mw-page-title-main">Ectopic pregnancy</span> Female reproductive system health issue

Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these symptoms. The pain may be described as sharp, dull, or crampy. Pain may also spread to the shoulder if bleeding into the abdomen has occurred. Severe bleeding may result in a fast heart rate, fainting, or shock. With very rare exceptions, the fetus is unable to survive.

<span class="mw-page-title-main">Hysterectomy</span> Surgical removal of the uterus

Hysterectomy is the surgical removal of the uterus and cervix. Supracervical hysterectomy refers to removal of the uterus while the cervix is spared. These procedures may also involve removal of the ovaries (oophorectomy), fallopian tubes (salpingectomy), and other surrounding structures. The term “partial” or “total” hysterectomy are lay-terms that incorrectly describe the addition or omission of oophorectomy at the time of hysterectomy. These procedures are usually performed by a gynecologist. Removal of the uterus renders the patient unable to bear children and has surgical risks as well as long-term effects, so the surgery is normally recommended only when other treatment options are not available or have failed. It is the second most commonly performed gynecological surgical procedure, after cesarean section, in the United States. Nearly 68 percent were performed for conditions such as endometriosis, irregular bleeding, and uterine fibroids. It is expected that the frequency of hysterectomies for non-malignant indications will continue to fall given the development of alternative treatment options.

A hysterotomy is an incision made in the uterus. This surgical incision is used in several medical procedures, including during termination of pregnancy in the second trimester and delivering the fetus during caesarean section. It is also used to gain access and perform surgery on a fetus during pregnancy to correct birth defects, and it is an option to achieve resuscitation if cardiac arrest occurs during pregnancy and it is necessary to remove the fetus from the uterus.

<span class="mw-page-title-main">Müllerian agenesis</span> Congenital malformation of female reproductive organs

Müllerian agenesis, also known as Müllerian aplasia, vaginal agenesis, or Mayer–Rokitansky–Küster–Hauser syndrome, is a congenital malformation characterized by a failure of the Müllerian ducts to develop, resulting in a missing uterus and variable degrees of vaginal hypoplasia of its upper portion. Müllerian agenesis is the cause in 15% of cases of primary amenorrhoea. Because most of the vagina does not develop from the Müllerian duct, instead developing from the urogenital sinus, along with the bladder and urethra, it is present even when the Müllerian duct is completely absent. Because ovaries do not develop from the Müllerian ducts, affected people might have normal secondary sexual characteristics but are infertile due to the lack of a functional uterus. However, biological motherhood is possible through uterus transplantation or use of gestational surrogates.

<span class="mw-page-title-main">Asherman's syndrome</span> Medical condition

Asherman's syndrome (AS) is an acquired uterine condition that occurs when scar tissue (adhesions) forms inside the uterus and/or the cervix. It is characterized by variable scarring inside the uterine cavity, where in many cases the front and back walls of the uterus stick to one another. AS can be the cause of menstrual disturbances, infertility, and placental abnormalities. Although the first case of intrauterine adhesion was published in 1894 by Heinrich Fritsch, it was only after 54 years that a full description of Asherman syndrome was carried out by Joseph Asherman. A number of other terms have been used to describe the condition and related conditions including: uterine/cervical atresia, traumatic uterine atrophy, sclerotic endometrium, and endometrial sclerosis.

<span class="mw-page-title-main">Artificial womb</span> Device that would allow for extracorporeal pregnancy

An artificial womb or artificial uterus is a device that would allow for extracorporeal pregnancy by growing a fetus outside the body of an organism that would normally carry the fetus to term.

<span class="mw-page-title-main">Uterine malformation</span> Medical condition

A uterine malformation is a type of female genital malformation resulting from an abnormal development of the Müllerian duct(s) during embryogenesis. Symptoms range from amenorrhea, infertility, recurrent pregnancy loss, and pain, to normal functioning depending on the nature of the defect.

<span class="mw-page-title-main">Uterine rupture</span> Medical condition

Uterine rupture is when the muscular wall of the uterus tears during pregnancy or childbirth. Symptoms, while classically including increased pain, vaginal bleeding, or a change in contractions, are not always present. Disability or death of the mother or baby may result.

<span class="mw-page-title-main">Uterine myomectomy</span> Surgical removal of uterine fibroid

Myomectomy, sometimes also called fibroidectomy, refers to the surgical removal of uterine leiomyomas, also known as fibroids. In contrast to a hysterectomy, the uterus remains preserved and the woman retains her reproductive potential. It still may impact hormonal regulation and the menstrual cycle.

<span class="mw-page-title-main">Male pregnancy</span> Pregnancy in males

Male pregnancy is the incubation of one or more embryos or fetuses by organisms of the male sex in some species. Most species that reproduce by sexual reproduction are heterogamous—females producing larger gametes (ova) and males producing smaller gametes (sperm). In nearly all animal species, offspring are carried by the female until birth, but in fish of the family Syngnathidae, males perform that function.

<span class="mw-page-title-main">Abdominal pregnancy</span> Medical condition

An abdominal pregnancy is a rare type of ectopic pregnancy where the embryo or fetus is growing and developing outside the uterus, in the abdomen, and not in a fallopian tube, an ovary, or the broad ligament.

<span class="mw-page-title-main">Fetal surgery</span> Growing branch of maternal-fetal medicine

Fetal surgery also known as antenatal surgery, prenatal surgery, is a growing branch of maternal-fetal medicine that covers any of a broad range of surgical techniques that are used to treat congenital abnormalities in fetuses who are still in the pregnant uterus. There are three main types: open fetal surgery, which involves completely opening the uterus to operate on the fetus; minimally invasive fetoscopic surgery, which uses small incisions and is guided by fetoscopy and sonography; and percutaneous fetal therapy, which involves placing a catheter under continuous ultrasound guidance.

<span class="mw-page-title-main">Uterus didelphys</span> Medical condition

Uterus didelphys represents a uterine malformation where the uterus is present as a paired organ when the embryogenetic fusion of the Müllerian ducts fails to occur. As a result, there is a double uterus with two separate cervices, and possibly a double vagina as well. Each uterus has a single horn linked to the ipsilateral fallopian tube that faces its ovary.

<span class="mw-page-title-main">Interstitial pregnancy</span> Medical condition

An interstitial pregnancy is a uterine but ectopic pregnancy; the pregnancy is located outside the uterine cavity in that part of the fallopian tube that penetrates the muscular layer of the uterus. The term cornual pregnancy is sometimes used as a synonym, but remains ambiguous as it is also applied to indicate the presence of a pregnancy located within the cavity in one of the two upper "horns" of a bicornuate uterus. Interstitial pregnancies have a higher mortality than ectopics in general.

Definitions of abortion vary from one source to another. Abortion has many definitions that can differ from each other in significant ways. Given the contentious nature of abortion, lawmakers and other stakeholders often face controversy in defining abortion. Language referring to abortion often reflects societal and political opinions . Influential non-state actors like the United Nations and the Roman Catholic Church have also engendered controversy over efforts to define abortion.

Transgender pregnancy is the gestation of one or more embryos or fetuses by transgender people. As of 2023, the possibility is restricted to those born with female reproductive systems. However, transition-related treatments may impact fertility. Transgender men and nonbinary people who are or wish to become pregnant face social, medical, legal, and psychological concerns. As uterus transplantations are currently experimental, and none have successfully been performed on trans women, they cannot become pregnant.

<span class="mw-page-title-main">Use of assisted reproductive technology by LGBT people</span>

Lesbian, gay, bisexual, and transgender people people wishing to have children may use assisted reproductive technology. In recent decades, developmental biologists have been researching and developing techniques to facilitate same-sex reproduction.

References

  1. ↑ Knauer, Emil (1896). "Einige Versuche über Ovarientransplantation bei Kaninchen" [An attempt at ovary transplantation in rabbits]. Zentralblatt für Gynäkologie (in German). 20: 524–8.
  2. ↑ Nugent, D.; Meirow, D.; Brook, P. F.; Aubard, Y.; Gosden, R. G. (1997). "Transplantation in reproductive medicine: Previous experience, present knowledge and future prospects". Human Reproduction Update. 3 (3): 267–80. doi: 10.1093/humupd/3.3.267 . PMID   9322102.
  3. ↑ Eraslan, S.; Hamernik, R. J.; Hardy, J. D. (1966). "Replantation of uterus and ovaries in dogs, with successful pregnancy". Archives of Surgery. 92 (1): 9–12. doi:10.1001/archsurg.1966.01320190011002. PMID   5948103.
  4. ↑ Díaz-García, César; Akhi, Shamima N.; Wallin, Ann; Pellicer, Antonio; Brännström, Mats (2010). "First report on fertility after allogeneic uterus transplantation". Acta Obstetricia et Gynecologica Scandinavica. 89 (11): 1491–1494. doi: 10.3109/00016349.2010.520688 . PMID   20879912. S2CID   1188699.
  5. ↑ Brännström, Mats; Racowsky, Catherine; Richards, Elliott G.; Flyckt, Rebecca; Stillman, Robert J.; O’Brien, Jeanne E.; Ryan, Ginny L.; de Ziegler, Dominique (June 2023). "Absolute uterine infertility a cornelian dilemma: uterine transplantation or surrogacy?". Fertility and Sterility. 119 (6): 918–929. doi: 10.1016/j.fertnstert.2023.04.005 . PMID   37037300.
  6. ↑ "Woman receives sister's womb in first UK transplant". BBC News. 2023-08-22. Retrieved 2023-08-27.
  7. ↑ Kroløkke, C.; Petersen, T.S.; Herrmann, J.R.; Bach, A.S.; Adrian, S.W.; Klingenberg, R.; Petersen, M.N. (2019). The Cryopolitics of Reproduction on Ice: A New Scandinavian Ice Age. Emerald Studies in Reproduction, Culture and Society. Emerald Publishing Limited. p. 154. ISBN   978-1-83867-044-3 . Retrieved 2023-02-22.
  8. ↑ "Lili Elbe". Biography. Retrieved 2019-02-25.
  9. 1 2 3 Grady, Denise (March 7, 2002). "Medical First: A Transplant Of a Uterus". The New York Times.
  10. ↑ Nair, Anjana; Stega, Jeanetta; Smith, J. Richard; Del Priore, Giuseppe (2008). "Uterus Transplant". Annals of the New York Academy of Sciences. 1127: 83–91. doi:10.1196/annals.1434.003. PMID   18443334. S2CID   5100080.
  11. 1 2 3 Lefkowitz, Ariel; Edwards, Marcel; Balayla, Jacques (2012). "The Montreal Criteria for the Ethical Feasibility of Uterine Transplantation". Transplant International. 25 (4): 439–47. doi:10.1111/j.1432-2277.2012.01438.x. PMID   22356169. S2CID   39516819.
  12. ↑ "Turkish woman has world's first womb transplant". timesofmalta.com. 10 October 2011. Retrieved 2012-11-21.
  13. ↑ "Revolutionary 'Womb Transplant' performed in Turkey - World's First". Allvoices.com. Retrieved 2012-11-21.
  14. ↑ "World's first womb transplant in Turkey promises hope for women". Alarabiya.net. 2011-10-01. Retrieved 2012-11-21.
  15. ↑ "HEALTH - Doctors hopeful for uterus transplant". Hurriyetdailynews.com. 2011-09-13. Retrieved 2012-11-21.
  16. ↑ "World's first uterus transplant performed in Turkey/TRT-English". Trt-world.com. 2012-02-27. Retrieved 2012-11-21.
  17. ↑ "Turkish surgeons perform world's first uterus transplant | Family & Health". World Bulletin. Retrieved 2012-11-21.
  18. ↑ "Womb transplant recipient Derya Sert pregnant". AAP. 2013-04-13.
  19. ↑ "Yahoo Health". 12 April 2013. Retrieved 5 October 2014.
  20. ↑ "World's first woman with uterus transplant gets pregnant - HEALTH". 14 April 2013. Retrieved 5 October 2014.
  21. ↑ Derya Sert'in gebeliği sonlandırıldı. CNNTurk.com. (in Turkish)
  22. ↑ "Kadavradan rahim nakli yapılan Derya Sert anne oldu" [Derya Sert, receiver of a uterus transplant from a cadaver, has become a mother] (in Turkish). Anadolu Agency. 2020-06-26.
  23. 1 2 Brännström, Mats; Johannesson, Liza; Dahm-Kähler, Pernilla; Enskog, Anders; Mölne, Johan; Kvarnström, Niclas; Diaz-Garcia, Cesar; Hanafy, Ash; Lundmark, Cecilia; Marcickiewicz, Janusz; Gäbel, Markus; Groth, Klaus; Akouri, Randa; Eklind, Saskia; Holgersson, Jan; Tzakis, Andreas; Olausson, Michael (2014). "First clinical uterus transplantation trial: a six-month report". Fertility and Sterility. 101 (5): 1228–1236. doi: 10.1016/j.fertnstert.2014.02.024 . PMID   24582522.
  24. ↑ Brännström, Mats; Diaz-Garcia, Cesar; Hanafy, Ash; Olausson, Michael; Tzakis, Andreas (2012). "Uterus transplantation: animal research and human possibilities". Fertility and Sterility. 97 (6): 1269–1276. doi: 10.1016/j.fertnstert.2012.04.001 . PMID   22542990.
  25. ↑ Brännström, M.; Wranning, C. A.; Altchek, A. (7 November 2009). "Experimental uterus transplantation". Human Reproduction Update. 16 (3): 329–345. doi: 10.1093/humupd/dmp049 . PMID   19897849.
  26. ↑ "Woman has healthy baby boy after womb transplant in Sweden". ABC News. 4 October 2014.
  27. ↑ Brännström, M.; Johannesson, L.; Bokström, H.; Kvarnström, N.; Mölne, J.; Dahm-Kähler, P.; Enskog, A.; Milenkovic, M.; Ekberg, J.; Diaz-Garcia, C.; Gäbel, M.; Hanafy, A.; Hagberg, H.; Olausson, M.; Nilsson, L. (2014). "Livebirth after uterus transplantation". The Lancet. 385 (9968): 607–616. doi:10.1016/S0140-6736(14)61728-1. hdl: 10072/141149 . PMID   25301505. S2CID   20244453.
  28. ↑ "BBC News - Womb transplant couple 'had no doubt' of success". BBC News.
  29. ↑ Zeltner, Brie (2016-03-07). "Cleveland Clinic introduces nation's first uterus transplant recipient". The Plain Dealer . Retrieved 2016-03-08.
  30. ↑ Zeltner, Brie (2016-03-09). "Nation's first uterus transplant, performed at the Cleveland Clinic, fails". The Plain Dealer. Retrieved 2016-03-10.
  31. ↑ Denise Grady (April 8, 2016). "Yeast Infection Led to Removal of Transplanted Uterus". The New York Times. Retrieved April 8, 2016.
  32. ↑ Sifferlin, Alexandra (2017-12-01). "First U.S. Baby Born After a Uterus Transplant". Time . Retrieved 2019-03-29.
  33. ↑ "The first baby in the U.S. born via uterus transplant is here". December 2017. Retrieved 9 January 2018.
  34. ↑ Flyckt, R.; Falcone, T.; Quintini, C.; et al. (August 2020), "First birth from a deceased donor uterus in the United States: from severe graft rejection to successful cesarean delivery", American Journal of Obstetrics and Gynecology, 223 (2): 143–151, doi:10.1016/j.ajog.2020.03.001, PMID   32151611, S2CID   212651317
  35. 1 2 Pinheiro, Lara (5 December 2018). "Caso do primeiro bebê nascido de transplante de útero com doadora falecida é publicado em revista". G1. Retrieved 13 July 2022.
  36. ↑ "India's first uterine transplant to take place on 18 May: Baroda woman to receive womb from mother". Firstpost. 12 May 2017. Retrieved 12 May 2017.
  37. 1 2 "Miracle baby: the first uterine transplant baby born in India". Mom And Baby Care (Mom ABC). 2018-11-01. Retrieved 2018-11-05.
  38. ↑ Arora, Medhavi. "Mom donates womb to daughter in India's first uterus transplant". CNN. Retrieved 2018-11-05.
  39. 1 2 Ejzenberg, Dani; Andraus, Wellington; Baratelli Carelli Mendes, Luana Regina; Ducatti, Liliana; Song, Alice; Tanigawa, Ryan; Rocha-Santos, Vinicius; MacEdo Arantes, Rubens; Soares, José Maria; Serafini, Paulo Cesar; Bertocco De Paiva Haddad, Luciana; Pulcinelli Francisco, Rossana; Carneiro d'Albuquerque, Luiz Augusto; Chada Baracat, Edmund (2018). "Livebirth after uterus transplantation from a deceased donor in a recipient with uterine infertility". The Lancet. 392 (10165): 2697–2704. doi:10.1016/S0140-6736(18)31766-5. PMID   30527853 . Retrieved 2022-07-13.
  40. ↑ Varghese, Rebecca Rose (2023-09-28). "What does it mean to have a uterus transplant? | Explained". The Hindu. ISSN   0971-751X . Retrieved 2023-09-28.
  41. ↑ Desk, India TV News; News, India TV (2023-08-24). "Woman donates her womb to younger sister; Britain's first successful uterus transplant". www.indiatvnews.com. Retrieved 2023-09-28.{{cite web}}: |last2= has generic name (help)
  42. ↑ "Woman receives sister's womb in first UK transplant". BBC News. 2023-08-22. Retrieved 2023-09-28.
  43. ↑ Australia's first uterus transplant recipient Kirsty Bryant gives birth to healthy baby boy, Emma Siossian , ABC News Online, 2023-12-19
  44. ↑ Ossola, Alexandra (18 February 2014). "Everything You Need To Know About Uterus Transplants". Popular Science. Retrieved 10 October 2014.
  45. ↑ "Medical first: Baby born to woman who got new womb". Journal Star . 2006-2014 Gatehouse Media, Inc. 4 October 2014. Retrieved 4 October 2014.
  46. ↑ "BBC News". 4 October 2014. Retrieved 5 October 2014.
  47. ↑ "The Daily Telegraph". Telegraph.co.uk. 3 October 2014. Archived from the original on 4 October 2014. Retrieved 5 October 2014.
  48. ↑ Johannesson, Liza; Diaz-Garcia, Cesar; Leonhardt, Henrik; Dahm-Kähler, Pernilla; Marcickiewicz, Janusz; Olausson, Michael; Brännström, Mats (2012). "Vascular Pedicle Lengths After Hysterectomy". Obstetrics & Gynecology. 119 (6): 1219–1225. doi:10.1097/AOG.0b013e318255006f. PMID   22617587. S2CID   9423625.
  49. 1 2 Brännström, M.; Wranning, C. A.; Altchek, A. (2009). "Experimental uterus transplantation". Human Reproduction Update. 16 (3): 329–45. doi: 10.1093/humupd/dmp049 . PMID   19897849.
  50. ↑ Wranning, C. A.; Akhi, S. N.; Diaz-Garcia, C.; Brännström, M. (15 December 2010). "Pregnancy after syngeneic uterus transplantation and spontaneous mating in the rat". Human Reproduction. 26 (3): 553–558. doi: 10.1093/humrep/deq358 . PMID   21159686.
  51. ↑ Enskog, A.; Johannesson, L.; Chai, D. C.; Dahm-Kahler, P.; Marcickiewicz, J.; Nyachieo, A.; Mwenda, J. M.; Brännström, M. (2 June 2010). "Uterus transplantation in the baboon: methodology and long-term function after auto-transplantation". Human Reproduction. 25 (8): 1980–1987. doi:10.1093/humrep/deq109. PMID   20519250.
  52. ↑ Dahm-Kähler, Pernilla; Wranning, Caiza; Lundmark, Cecilia; Enskog, Anders; Mölne, Johan; Marcickiewicz, Janusz; El-Akouri, Randa Racho; McCracken, John; et al. (2008). "Transplantation of the uterus in sheep: Methodology and early reperfusion events". Journal of Obstetrics and Gynaecology Research. 34 (5): 784–793. doi:10.1111/j.1447-0756.2008.00854.x. PMID   18834335. S2CID   20055019.
  53. ↑ Wranning, Caiza Almen; El-Akouri, Randa Racho; Lundmark, Cecilia; Dahm-Kahler, Pernilla; Molne, Johan; Enskog, Anders; Brännström, Mats (2006). "Auto-transplantation of the uterus in the domestic pig (Sus scrofa): Surgical technique and early reperfusion events". Journal of Obstetrics and Gynaecology Research. 32 (4): 358–367. doi:10.1111/j.1447-0756.2006.00426.x. PMID   16882260. S2CID   8576480.
  54. ↑ Lefkowitz A.; Edwards M.; Balayla J. (2012). "O081 the Montreal Criteria for the Ethical Feasibility of Uterine Transplantation". International Journal of Gynecology & Obstetrics. 119 (Supplement 3): S289. doi:10.1016/S0020-7292(12)60511-6. S2CID   76584337.
  55. ↑ Lefkowitz Ariel (2013). "Ethical considerations in the era of the uterine transplant: an update of the Montreal Criteria for the Ethical Feasibility of Uterine Transplantation". Fertility and Sterility. 100 (4): 924–926. doi: 10.1016/j.fertnstert.2013.05.026 . PMID   23768985.
  56. ↑ Balayla J.; Pounds P.; Lasry A.; Volodarsky-Perel A.; Gil A. (2021). "The Montreal Criteria and uterine transplants in transgender women". Bioethics. 35 (4): 326–330. doi:10.1111/bioe.12832. PMID   33550647. S2CID   231862917.
  57. ↑ Moore FD (2000). "Ethical problems special to surgery: surgical teaching, surgical innovation, and the surgeon in managed care". Arch Surg. 135 (1): 14–16. doi:10.1001/archsurg.135.1.14. PMID   10636340.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.