Monday, 10 December, 2018

Woman gives birth using womb transplanted from dead donor

The medical team after the baby's birth The medical team after the baby's birth. Divulgação Hospital das Clínicas da FMUSP
Samantha Long | 07 December, 2018, 23:53

But in the Brazilian woman's groundbreaking case, her new uterus was actually donated from a deceased donor, then used to successfully conceive and carry the child born previous year. The woman had been born with a rare genetic condition that left her without a uterus, known as Mayer-Rokitansky-Küster-Hauser syndrome, but she was otherwise healthy.

The transplant womb was taken from a mother-of-three who had died from bleeding on the brain. The baby girl was born via caesarean section on December 15, 2017, at 35 weeks of gestation.

The use of a deceased donor is a significant achievement that could greatly increase access to the procedure, said Stefan Tullius, chief of transplant surgery at Brigham and Women's Hospital in Boston who has participated in living donor uterus transplant surgery. But they said that relying on deceased donors could expand the options for women who do not have a friend or family member willing to donate or that would be a good match.

There have been 39 womb transplants using a live donor, including mothers donating their womb to their daughter, resulting in 11 babies. "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".

The case was proof-of-concept that deceased donor uterine transplantation was "a new option for women with uterine infertility" lead researcher and gynaecologist Dr Dani Ejzenberg said.

The whole field of uterus transplantation is in its early days.

The uterus was removed from the donor and transplanted into the recipient in a surgery that also involved connecting the donor uterus and recipient's veins and arteries, ligament and vaginal canals.

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.

"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".

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At the age of seven months, the baby continued to breastfeed and weighed 15lbs and 14oz (7.2 kilos).

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

Tragically, the pregnancy was determined to be unviable six weeks after conception and was terminated, calling into doubt whether uteruses provided by deceased donors could feasibly carry a new life completely through gestation.

She received five immunosuppression drugs to prevent her body rejecting the new organ, as well as other treatments to combat infection and blood clotting.

Doctors from the Cleveland Clinic transplanted a uterus from a deceased donor in 2016, but the procedure failed.

In this case, the recipient of the transplant was a patient who had uterine infertility.

"The first uterus transplants from live donors were a medical milestone", added Dr Ejzenberg.

Brazilian doctors are now planning more transplants following the procedure. But making the transition period even five months shorter means the recipient will need that much less medical care and powerful immunosuppressant drugs for their uterus to stay healthy.

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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