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First Baby Born After Uterus Transplant From Dead Donor
07 December 2018, 11:49 | Silvia Roy
A Brazilian baby will celebrate her first birthday later this month, less than two years after her mother-unable to carry a pregnancy because she lacked a uterus-underwent a transplant from a deceaseddonor.
Uterine factor infertility is infertility in women born without a uterus; loss of the organ due to hysterectomy, cancer or postpartum haemorrhage; or a congenital defect, such as the rare Mayer-Rokitankshy-Kuster-Hauser syndrome, which was the reason for the Brazilian woman's infertility.
A team in Brazil transplanted the womb from a dead 45-year-old woman into an infertile 32-year-old recipient, who went on to have a healthy baby girl. But in September 2016, surgeons at the University of São Paulo in Brazil conducted a 10-hour transplant operation to provide her with one taken from a dead donor.
The woman became pregnant through in vitro fertilization seven months after the transplant. In this case, a cesarean section was performed for birth at 35 weeks gestation, and along with the delivery of an nearly 6 pound healthy baby girl, the uterus was also removed.
Uterus transplantation was pioneered by Swedish doctor Mats Brannstrom, who has delivered eight children from women who got wombs from family members or friends.
The authors say their version of the procedure isn't meant to replace the possibility of using a living donor, but rather to give women with uterine problems another option.
Uterine transplants from deceased donors have been attempted previously, but until last December no recipient had carried a child to term.
"The use of deceased donors could greatly broaden access to this treatment", Dr. Dani Ejzenberg, who led the research, said in a statement.
It's still early days, but so far, there are no complaints.
A womb transplant is performed by removing the womb from the donor and transplanting it into the recipient by connecting the two major veins and a series of arteries, ligaments and vaginal canals, according to The Lancet.
"There are still lots of things we don't understand about pregnancies, like how embryos implant, ' said Dr. Cesar Diaz, who co-authored an accompanying commentary in the journal". The team said the baby girl was healthy and developing normally.
Singer stressed that pregnancies involving transplanted uteruses from deceased donors have failed in the past, but the Brazilian case is "an exciting step in the right direction".
As if this new case study is not impressive enough, it is also the first uterine transplantation of any kind to take place in Latin America.
"The increase in the number of centers performing this transplant, standardization of the surgical technique and immunosuppressive therapy can facilitate access to this new modality of treatment", he says.
The recipient of the transplant was a patient with uterine infertility.
At least a dozen children worldwide have been born to women with transplanted uteri donated by a living relative, but never one from a deceased donor. The uterus is removed and immunosuppressants are stopped after birth, according to the Royal College of Obstetricians and Gynaecologists.
With a living donor, the surgery can be scheduled when it's convenient for the surgeons, and there is time to do a thorough assessment of the donated organ to make sure it is suitable, she says.
However there are potential consequences to breakthroughs such as these, and not enough attention is being paid to the risks, professor Deborah Davis of the University of Canberra told 10 daily.
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