Wednesday, 19 December, 2018

First baby born via uterus transplanted from dead donor

Doctors hold a baby girl born to a mother who received a uterus from a deceased donor in Brazil. A novel transplantation procedure may help more infertile women become pregnant First baby born via uterus transplanted from dead donor
Melissa Porter | 06 December, 2018, 13:48

A woman in Brazil is the first in the world to give birth following a uterus transplant from a deceased donor in a medical milestone that potentially offers another treatment option for women with uterine-related infertility.

With live donors in short supply, doctors say the new technique might help to increase availability and give more women the option of pregnancy. The baby girl was born via caesarean section on December 15, 2017, at 35 weeks of gestation. The donor uterus was removed from the receiving patient during the c-section.

The mother, a 32-year-old woman, was born without a uterus due to Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, a condition affecting one in 4,500 women. After seven months, doctors implanted an embryo made using in vitro fertilization to spur the pregnancy. Uterine transplants from living donors have succeeded before, and babies have been born, but this donated uterus came from a deceased woman.

The 34-year-old woman from São Paulo, Brazil, underwent the procedure in 2016 under the guidance of Dr Dani Ejzenberg and his research team at the University Hospital of Sao Paulo.

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

Uterine transplants from living donors have succeeded; at least 11 babies have been born this way since 2013.

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. Removal of the donor organ also allowed the woman to stop taking immunosuppressant medication. Mother and baby were discharged from hospital three days later.

But the 10 previous transplants from a dead donor have failed or resulted in miscarriage.

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.

"Up till now it was not known that uterus can survive more than four hours out of a living body, however, the present case shows that the uterus is a quite strong an organ", Ms Sharma said.

Dr Wellington Andraus of the department of Gastroenterology at the University of Sao Paulo who also worked on the case study told Newsweek the woman's story is a "source of hope" for patients struggling with fertility caused by the uterus or a lack thereof.

The Brazilian researchers are planning two more uterus transplants as part of the study.

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.

"In an expanding field such as uterus transplantation, the role of collaborative networks and societies such as the International Society of Uterus Transplantation or new interest groups in already existing scientific societies will be crucial".

Although uterus transplants are a growing area of medicine, they remain highly experimental and are very hard surgeries to complete.

He said live uterus donors are rare and typically eligible family members or close friends of women seeking the transplant. Fifteen were fertilised, with 8 resulting in embryos that were subsequently preserved for later implantation.