Sunday, 16 December, 2018

First Baby Born Using Uterus Transplanted From Deceased Donor: Doctors

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
Johnnie Parks | 06 December, 2018, 13:50

The birth, in Brazil, is the first reported involving a deceased donor womb transplant.

"The number of people willing and committed to donate organs upon their own death are far larger than those of live donors, offering a much wider potential donor population", he said in a statement.

After seven months, the fertilised eggs were implanted.

11 other births have resulted from living donors, including women who donated their uteruses to their daughters.

The first baby born from a transplanted uterus arrived in Sweden in 2014.

The uterus transplant surgery, a first in Latin America, took more than 10 hours to complete.

The recipient had Mayer-Rokitansky-Küster-Hauser syndrome, which affects about one in every 4500 women and results in the vagina and uterus (womb) failing to form properly.

While babies born from live donor uterus transplants have been done almost a dozen times before, including once in 2017 at Baylor Scott & White Hospital in Dallas, this birth marks the first time doctors have been able to remove the uterus from a recently deceased donor and have it result in a live birth.

But Dr. Tullius said surrogacy comes with its own challenges, from compensation to the ethics of asking a woman to undergo the rigours of pregnancy.

"The Brazilian group has proven that using deceased donors is a viable option", said the Cleveland Clinic's Dr. Tommaso Falcone.

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The recipient had her first menstruation 37 days after the uterus transplant, and continued to have regular cycles after that. Removal of the donor organ also allowed the woman to stop taking immunosuppressant medication.

She stayed in intensive care for two days after the surgery and then spent six more on a specialised transplant ward.

A 6-pound baby girl was delivered through cesarean section, according to Dr. Dani Ejzenberg, a gynecologist at the Hospital das Clínicas at the Universidade de São Paulo in Brazil, who led the research. Mother and baby were discharged from hospital three days later.

"The successful case in our service brings hope to other centers that believe in this type of transplant", Ejzenberg said in an email to TIME.

But in the case of a uterus transplant from a cadaver, the potential danger for infections is more, says Kamini A. Rao, Medical Director, Milann-The Fertility Centre, Bengaluru. "While uterine transplantation sounds extreme, it can be indicated in women born without a uterus, or in women who have a non-functional or surgically-absent uterus". "While uterine surrogacy is legal in the USA, this offers an option, albeit an extreme and expensive one, to women who want to carry their own baby".

In the end, they held off an additional month after tests suggested the lining of the donor uterus wasn't quite thick enough to support implantation.

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.

After five months, the uterus showed no sign of rejection, ultrasound scans were normal, and the woman was menstruating regularly.

"They should also encourage forthcoming procedures to be done and reported in a transparent way by endorsing prospective registration of the procedures and by developing accurate registries".

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