First baby born following uterus transplant from deceased donor: case study

A medical team in São Paulo with a baby born via a uterine transplant.									Divulgação

Brazilian doctors have released the groundbreaking news that a woman has become the first in the world to have a baby with a uterus donated from a deceased person.

"This can be an important limitation when you don't have a close friend or a relative who can donate their uterus", said Doctor Wellington Andraus, the head transplant surgeon involved in the procedure. The baby was born by cesarean section between 34 and 36 weeks at the Hospital das Clinicas, University of Sao Paulo School of Medicine.

In the Brazilian case, the journal said the recipient had been born without a uterus due to a condition called Mayer-Rokitansky-Küster-Hauser syndrome.

The woman's previously fertilised and frozen eggs were implanted after seven months and, 10 days later, she was confirmed pregnant, it said. The donor was a 45-year-old woman who had three children and died of a stroke. Currently, only 10 known cases of uterus transplants from deceased donors exist, but all had failed to produce a live birth. The first successful uterine transplant (from a living donor) took place in 2013 in Sweden, and the woman who received the transplant gave birth in 2014.

"The use of deceased donors could greatly broaden access to this treatment, and our results provide proof-of-concept for a new option for women with uterine infertility", says lead researcher Dani Ejzenberg from Faculdade de Medicina da Universidade de São Paulo.

"The Brazilian group has proven that using deceased donors is a viable option", said the clinic's Dr. Tommaso Falcone, who was involved in the OH case.

He said any doubts he had about the potential importance of uterus transplants were erased after meeting the mother of the first baby born after a live donor uterus transplant.

Surgeons on the day of the birth of the baby girl to a woman with a uterus transplanted from a deceased donor.

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"The first uterus transplants from live donors were a medical milestone, creating the possibility of childbirth for many infertile women".

Swedish doctor Mats Brannstrom pioneered uterus transplantation. "Now she comes in to show us the baby and she is so happy".

In a transplant surgery that lasted more than ten hours, doctors had to connect the donor's uterus with the veins, arteries, ligaments, and vaginal canal of the recipient.

The Brazilian woman did not have any pregnancy problems, Ejzenberg says, but he removed the uterus during the C-section because he wants to focus on helping more women have a single child rather than on one woman having more than one.

In all those cases, the uteruses came from living women - often a family member or friend of the recipient.

In this trial, the mother was given standard doses of immune suppression medications for nearly six months, with positive results, before implantation of the embryo was completed.

Five months after the transplant, the implanted womb appeared to have been successfully incorporated into her body. And it's possible that patients won't need as many immunosuppressants as they now receive to stave off organ rejection. During the transplantation, there was a period of blood loss that was ultimately managed but might be avoidable in the future, by changing how the organ is initially reconnected to the woman's circulatory system, according to the study.

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