America’s first uterus transplant to aid pregnancy

Surgeons in Cleveland say they have performed America’s first uterus transplant. The aim is to give women who lack wombs a chance at pregnancy.

The Cleveland Clinic said the nine-hour surgery was performed on Wednesday, on a 26-year-old woman, using a uterus from a deceased donor.

The hospital had long been planning the surgery, announcing last autumn a clinical trial that would attempt 10 transplants. The hospital won’t release more details until a press conference next week, except to say the woman’s condition was stable.

Other countries have tried womb transplants — Sweden reported the first successful birth in 2014, and four since. Doctors there say the still-experimental treatment may be an alternative for the thousands of women unable to have children, either because they were born without a uterus or because they lost it to disease.

Others have questioned whether such an extreme step would be realistic for many women. It’s a procedure fraught with medical risk. The transplant may be rejected, and patients have to take potent, immune-suppressing drugs for a procedure that, unlike a donated kidney or heart, isn’t life-saving.

The Cleveland Clinic’s Dr Andreas Tzakis said the risks aren’t greater than those for other transplants, but it is considered life-enhancing, like transplants of the face or hand.

One important difference: “Unlike any other transplants, they are ‘ephemeral’,” Tzakis said last year, in a statement announcing the study. “They are not intended to last for the duration of the recipient’s life, but will be maintained for only as long as is necessary to produce one or two children.”

Removing a uterus from a deceased donor is more complex than a hysterectomy, as the major arteries also must be removed. The womb and blood vessels are sewn inside the recipient’s pelvis.

Before closing the abdomen, surgeons check for good blood flow and that the attachment to the ligaments is strong enough to maintain a pregnancy.

If a woman is approved for a transplant in the study, she would first have to have eggs removed from her ovaries, like is done for in-vitro fertilisation, and then have the embryos frozen. Those could be implanted only 12 months after the transplant heals, if it’s successful.

The hospital said it would attempt transplants in women who have what’s called uterine-factor infertility. This means they were born without a uterus or with uterine abnormalities that block pregnancy.


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