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

Henrietta Brewer
December 7, 2018

A woman who was transplanted with a deceased donor's womb has given birth to a baby girl, researchers in Brazil say.

The team carefully dissected the uterus from the donor before carrying out the 10-and-a-half-hour operation in September 2016 to insert the organ, which weighed 225g.

In the successful case, published Tuesday in The Lancet, the donor was a 45-year-old mother of three who died from a rare type of stroke, and also donated her heart, liver and kidneys.

A baby girl weighing 2.55kg (6.6lbs) was born by caesarean section after a pregnancy lasting 35 weeks and three days. Almost a year later, mother and baby are both healthy.

At least a dozen children worldwide have been born to women with transplanted uteri donated by a living relative, but never one from a deceased donor. Baylor has had two successful births from live donations; Cleveland Clinic is working toward deceased donations; and her own program will be performing both living and deceased donor transplants over the next year.

Doctors believe the procedure could help infertile women whose only options now are surrogacy or adoption.

The baby was born at 36 weeks old, with no complications. "The donors are rare, typically being willing and eligible family members or close friends".

Research leader Dr Dani Ejzenberg, of Universidade de Sao Paulo in Brazil, said: "The use of deceased donors could greatly broaden access to this treatment and our results provide proof-of-concept for a new option for women with uterine infertility".

Doctors said in the study that the woman felt "fulfilled" by the chance to carry and deliver her own daughter in spite of her condition.

No. In order to keep the uterus after birth, the mother would have to continue taking immune system suppression medications which can pose risks.

The oldest child born via uterine transplant - a boy - had just had his fourth birthday.

While researchers in countries including Sweden and the USA 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. This affects approximately 3 to 5 per cent of women, Dr. Tullius said, including those born without a uterus or those who have had hysterectomies for cancer-related reasons.

With this recent success comes not just the promise of greater access to donor organs, but vital information on what a transplanted uterus requires to successfully carry an embryo to full term. On the other hand, the researchers state that transplants from deceased donors might have some benefits over donations from live donors. This is the first time a woman has given birth with a deceased donor's uterus; some organs from live donors have figured in past births.

Five months after the transplantation, the uterus showed no signs of rejection. In the first, the uterus had to be removed from the recipient after an infection occurred; Flyckt said she couldn't say where things stood with the second case other than that the recipient was doing well.

"There is always a potential risk for the one who gives the uterus".

Until recently, the only options available to women with so-called uterine infertility were adoption or the services of a surrogate mother.

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".

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