December 5, 2018

expert reaction to first baby born by uterus transplant from a deceased donor

A paper published in The Lancet describes the first known case of livebirth following the transplant of a uterus from a deceased donor.

Richard Kennedy, President of the International Federation of Fertility Societies, 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. Uterine transplantation is a novel technique and should be regarded as experimental. As with all medical developments, wider adoption requires IRB approval with appropriate safeguards including adherence to authoritative guidelines, verification of relevant personnel and detailed transparent reporting of outcomes.”

Dr Srdjan Saso, Honorary Clinical Lecturer & Senior Registrar in Obstetrics and Gynaecology, Imperial College London, said:

 “Large number of women suffer from infertility secondary to poor uterine function. Reasons range from congenital malformation to iatrogenic causes. For such women, the only available options to have a child are adoption or surrogacy. To these two options, we can now add uterine transplantation following the first childbirth from a living donor in 2013 in Sweden.

“Since then, research interest in this recent, and still experimental field in many countries, has been steadily growing. We mustcongratulate the authors on this timely first report of a livebirth after uterus transplantation from a deceased donor. For those of us involved in uterine transplantation research, it is extremelyexciting to now have two proofs-of-concept for a new treatment option for absolute uterine factor infertility. In this case, the treatment option is for women without a living donor.

“This is particularly important, as all previous successful livebirths were from patients who received a uterine transplant from a live donor. The only other pregnancy following a uterine transplantation from a deceased donor was in 2011 in Turkey. This attempt was unsuccessful and led to miscarriage two years later, which led to doubts whether deceased donation could work. However, this successful demonstration demonstrates a few advantages over live donation. It enables use of a much wider potential donor population, applies lower costs and avoids live donors’ surgical risks.

“We should also acknowledge the team’s decision to follow accepted protocols in uterine transplantation. Their slight alterations will add to the science within the field. In particular, shortening the time between the transplant and embryo transfer, modifying the number of venous anastomoses that can be used to improve venous drainage, and maintenance of the viability of the explanted uterus after eight hours of ischaemia, more than double that previously described for those of live donors.

“Our hope, as we plan to kick-start the UK programme at the beginning of 2019, is for the deceased donor uterine transplant programme to grow alongside its ‘live donor’ counterpart, proveachievable and successful so that both women with willing donors in their families, and those not, can have a real option of carrying a healthy pregnancy.”

Prof. Andrew Shennan, Professor of Obstetrics, Kings College London, said:

 “Uterine transplant and subsequent pregnancies, including from live donors have previously been reported, but this is the first case of a successful pregnancy from a deceased donor. Successful pregnancy, without evidence of any compromise in spite of the uterus (womb) being without oxygen for 8 hours before transplant, was unique. This opens the possibility of women donating their womb following death, as with many other organs. This allows a further option for women with uterine problems preventing them having a baby to carry their own child, rather than relying on live donors, a surrogate or adoption.”

‘Livebirth after uterus transplantation from a deceased donor in a recipient with uterine infertility’ by Ejzenberg et al. was published in The Lancet at 23:30 UK time on Tuesday 4th December.preg

Declared interests

Prof. Andrew Shennan: “I have no conflicts.”

None others received