Education Corner – Uterus Transplantation

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Paving the way

  • The first successful uterus transplants were performed in Sweden.
  • They have resulted in five live births to date and the uteri came from living donors.
  • About a decade of research and clinical trial collaboration has occurred between the Swedish team and the Cleveland Clinic.

A first in the U.S.

The first U.S. uterus transplant was performed in February of 2016:

  • The Cleveland Clinic is administering the U.S.’s first clinical trial of uterus transplantation for reproductive age women with Uterine Factor Infertility (UFI).
  • UFI: pregnancy is impossible due to being born without a uterus, uterus having been removed, or uterus non-functioning; affects 3 to 5 million women worldwide.
  • 10 participants (age 21-29 with UFI) are planned for the clinical trial.
  • The uterus transplant is intended to be a temporary transplant to allow a woman her only opportunity to carry a pregnancy
    • The uterus would remain in situ for 1-2 pregnancies after which anti-rejection medications would be discontinued and the uterus removed or allowed to disintegrate.
  • The first transplant at the Cleveland Clinic, lasted more than 9 hours.
  • Soon after the transplant, the uterus was removed following a sudden complication due to an infection that affected blood supply to the organ.

How Uterus Transplantation Works

The planned uterus transplantation process:YouTube_uterus

  • Recipient candidate screening and selection.
  • Donor identification: age 18-40 with a healthy uterus.
  • Recipient IVF initiated; 6-10 embryos frozen.
  • Anti-rejection meds initiated; donor uterus and blood supply transplanted.
  • Uterus heals after 12 months; embryos implanted one by one.
  • Anti-rejection drugs given throughout pregnancy; monthly cervical biopsies performed to monitor for rejection.
  • Baby delivered by C-section; anti-rejection meds halted after 1-2 babies.
  • See Cleveland Clinic’s infographic for more facts about uterus transplant.
  • Read Q & A with lead surgeon Dr. Andreas Tzakis
  • Watch animation video (click on image)

What Now?

Three additional programs reportedly plan to launch experimental uterus transplants: Baylor University Medical Center at Dallas, Brigham and Women’s Hospital in Boston, and the University of Nebraska Medical Center in Omaha (New York Times)

A special thanks to Elizabeth Spencer from Elizabeth Katherine Communications LLC for her contributions to this issue.

References:
Cleveland Clinic http://www.clevelandclinic.org/lp/uterus-transplant/index.html
The Lancet, Livebirth after uterus transplantation (Feb 14, 2015) http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61728-1/abstract
The Denise Grady (March 9, 2016). First US Transplant Has Failed. The New York Times. Retrieved from http://www.nytimes.com/2016/03/10/health/first-uterus-transplant-in-us-has-failed.html?_r=0

Editor: Hedi Aguiar RN, MSN, Director of Programs and Communications, The Alliance, haguiar@odt-alliance.org.
This Education Corner is available for download. The Alliance grants permission for the distribution and reproduction of this educational communication.

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