The Evolution of Transplantation From Saving Lives to Fertility Treatment: DUETS (Dallas UtErus Transplant Study)

OBJECTIVE:We report the results of the first 20 uterus transplants performed in our institution. SUMMARY BACKGROUND DATA:Uterus transplantation (UTx) aims at giving women affected by absolute uterine-factor infertility the possibility of carrying their own pregnancy. UTx has evolved from experimenta...

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Veröffentlicht in:Annals of surgery 2020-09, Vol.272 (3), p.411-417
Hauptverfasser: Testa, Giuliano, McKenna, Greg J., Bayer, Johanna, Wall, Anji, Fernandez, Hoylan, Martinez, Eric, Gupta, Amar, Ruiz, Richard, Onaca, Nicholas, Gunby, Robert T., Gregg, Anthony R., Olausson, Michael, Koon, E. Colin, Johannesson, Liza
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Sprache:eng
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Zusammenfassung:OBJECTIVE:We report the results of the first 20 uterus transplants performed in our institution. SUMMARY BACKGROUND DATA:Uterus transplantation (UTx) aims at giving women affected by absolute uterine-factor infertility the possibility of carrying their own pregnancy. UTx has evolved from experimental to an established surgical procedure. METHODS:The Dallas Uterus Transplant Study (DUETS) program started in 2016. The uterus was transplanted in orthotopic position with vascular anastomoses to the external iliac vessels and removed when 1 or 2 live births were achieved. Immunosuppression lasted only for the duration of the uterus graft. RESULTS:Twenty women, median age 29.7 years, enrolled in the study, with 10 in phase 1 and 10 in phase 2. All but 2 recipients had a congenital absence of the uterus. Eighteen recipients received uteri from living donors and 2 from deceased donors. In phase 1, 50% of recipients had a technically successful uterus transplant, compared to 90% in phase 2. Four recipients with a technical success in phase 1 have delivered 1 or 2 babies, and the fifth recipient with a technical success is >30 weeks pregnant. In phase 2, 2 recipients have delivered healthy babies and 5 are pregnant. CONCLUSIONS:UTx is a unique type of transplant; whose only true success is a healthy child birth. Based on results presented here, involving refinement of the surgical technique and donor selection process, UTx is now an established solution for absolute uterine-factor infertility.
ISSN:0003-4932
1528-1140
DOI:10.1097/SLA.0000000000004199