Wednesday, 19 December, 2018

First Successful Uterus Transplant from Deceased Donor Leads to Healthy Baby

Dr. Wellington Andraus  AP Dr. Wellington Andraus AP
Melissa Porter | 07 December, 2018, 23:57

A team of doctors in Brazil has announced the birth of the first healthy baby via a donor uterus from a dead person.

She was born in December 2017 but details of the case were only released yesterday in The Lancet Journal. 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.

"The first uterus transplants from live donors were a medical milestone, creating the possibility of childbirth for many infertile women".

"The numbers of people willing and committed to donate organs upon their own deaths are far larger than those of live donors, offering a much wider potential donor population", said Dr Ejzenberg in a statement about the procedure.

"This is a very important birth for the whole uterus transplant community", said Dr. Liza Johannesson, a uterus transplant surgeon at Baylor who previously worked with the Swedish research team.

The Brazilian doctors are confident this successful attempt will give more options for uterus transplants in the future, having already planned two more transplants as a part of their study.

Experts say the case study shows that uterus transplants from dead donors are feasible and may open access for all women with uterine infertility, without the need for live donors. With live donors often in short supply, it's hoped this bold breakthrough from Brazil could offer hope to the 1 in 500 people who experience infertility problems from uterine anomalies.

Infertility, in general, affects about 15% of couples of reproductive age. But donors are hard to find and the surgical procedure to remove.

She received five immunosuppression drugs to prevent her body rejecting the new organ, as well as other treatments to combat infection and blood clotting. Immunosuppression therapy continued after she left the hospital until the time of her baby's birth.

The healthy baby girl was born via cesarean section at Hospital das Clínicas, at the University of São Paulo School of Medicine, after her mother underwent a uterine transplant followed by an In vitro fertilization (IVF) pregnancy just seven months later.

The oldest child born via uterine transplant - a boy - had just had his fourth birthday. Ten days later, doctors delivered the good news: she was pregnant.

Besides a minor kidney infection - treated with antibiotics - during the 32nd week, the pregnancy was normal.

The girl born in the Brazilian case was delivered via caesarean section at 35 weeks and three days, and weighed 2,550 grams, the case study said.

During the delivery, the transplanted womb was removed and showed no abnormalities.

The mother and baby were discharged from the hospital three days after birth. Those transplants can only be done for women who find a donor, who must undergo a complicated surgery and lengthy recovery, Dr. Tullius said.

Since then there have been 39 such procedures, resulting in 11 live births.

In all those cases, the uteruses came from living women - often a family member or friend of the recipient.

An accompanying editorial in the Lancet said the procedure was in its early stages and "many questions are still unsolved" including optimal surgical techniques, drug regimen and best-suited patients.

"But you can't underestimate the desperation some women feel when they can't have children".