First baby born following uterus transplant from deceased donor: case study

Laverne Higgins
December 7, 2018

Brazilian doctors are reporting the world's first baby born to a woman who received a uterus transplanted from a deceased donor.

The Lancet reports that the mother had Mayer-Rokitansky-Küster-Hauser syndrome, a condition that causes the uterus and vagina to not develop properly. The deceased uterus donor was a 45-year old woman who died from a subarachnoid hemorrhage. And just seven months after the operation, doctors began in vitro fertilization, through which the woman's own fertilized eggs - which had been harvested prior to the transplant surgery - were transferred to her new uterus.

Doctors say the woman had a healthy and fairly typical pregnancy, before giving birth via c-section to a six-pound baby girl previous year.

This technique has been done eleven times before using the uterus of a living donor. But all of the other successful deliveries so far have been made possible by living donors - often women who opt to donate their uterus to a close friend or family member without one.

Eleven children have been born following uterine transplantation from living donors, the first of which occurred in Sweden in September 2013.

But crucially, similar transplants have been done with fetuses which came from a live donor.

Researchers say the case study, published Tuesday in The Lancet, shows that such transplants from deceased donors are feasible and may increase options for women struggling with uterine infertility.

The whole field of uterus transplantation is in its early days.

"It enables use of a much wider potential donor population, applies lower costs and avoids live donors' surgical risks", Saso stated.

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Richard Kennedy, president of the International Federation of Fertility Societies (IFFS), said: "The IFFS 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".

Ten days after implantation, the recipient was confirmed to be pregnant.

It also "eliminates the main challenge", Singer added, "which is finding a matching donor and risking the lives of live donors who have to otherwise undergo a major surgery to remove their uterus".

"They should promote education and guidance so that the groups performing uterus transplantation for the first time can benefit from the experience of the pioneers".

At the age of seven months, the baby continued to breastfeed and weighed 15lbs and 14oz (7.2 kilos). Flyckt and her colleagues in Cleveland have also performed two transplants from deceased donors.

The recipient received five immunosuppression drugs (needed to prevent rejection of the new uterus by the body), antibiotics, anti-blood clotting treatment and aspirin while in hospital.

Women who have irreversible infertility are the primary candidates to receive a transplant.

The researchers in Brazil reported that the uterus was ischemic - meaning, off a blood supply - for nearly eight hours, essentially double the reported time from any of the living donor transplants. The uterus was removed from recipient post that.

Researchers not involved in the study cautioned that, given all the biological constraints, the pool of potential uterus donors is actually quite small, even taking into account deceased donors. Uterine transplants are considered "ephemeral", meaning they only stay in to allow the recipient to have children and are then removed.

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