For the first time, a baby was born via uterus transplant from a deceased donor
A baby was born through a uterus transplant from a deceased donor in Brazil, making medical history.
The birth, which was documented in a case study in The Lancet on Thursday, is also the first uterine transplant in Latin America.
Authors noted this case could open more doors for women dealing with uterine infertility without using a live donor. At the moment, uterus donations are only available for women with family members who are willing to donate. These donors also have to be alive.
With very few live donors in the first place, this new technique could help more women in need down the road.
“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.” Dr. Dani Ejzenberg at the Hospital das Clínicas in São Paulo, Brazil, who lead the study, said in a statement.
Credit: Hospital das Clínicas da FMUSP
“The first uterus transplants from live donors were a medical milestone, creating the possibility of childbirth for many infertile women with access to suitable donors and the needed medical facilities,” Eizeberg continued.
“The numbers of people willing and committed to donate organs upon their own deaths are far larger than those of live donors, offering a much wider potential donor population.”
The surgery, which was done in September 2016, took 10.5 hours to complete. The mother-to-be was a 32-year-old woman who was born with Mayer-Rokitansky-Küster-Hauser syndrome, and as a result, she didn’t have a uterus. “She had one in vitro fertilization cycle four months before transplant, resulting in eight fertilized eggs which were cryopreserved,”the authors added.
The donor was a 45-year-old woman who died of a subarachnoid haemorrhage, a stroke that causes bleeding on the surface of the brain. The surgery involved connecting the deceased woman’s uterus with the recipient’s veins, arteries, ligaments and vaginal canal.
Five months after the surgery, the woman’s body wasn’t rejecting the uterus and a scan showed no anomalies. She was even having regular periods. At the seven month mark, doctors planted the fertilized eggs in the patient. Authors note 10 days after implantation, the woman was pregnant. The fetus was documented as normal and an ultrasound revealed no anomalies.
Credit: Hospital das Clínicas da FMUSP
A baby girl was born at 35 weeks and weighed around six pounds. Today, at seven months, she continues to breastfeed.
Dr. Nicholas Leyland, professor and chair at the department of obstetrics and gynecology at McMaster University in Hamilton, Ont., told Global News there are some ethical concerns regarding this case study.
“There are a number of other options to allow [women] to have successful pregnancies without incurring risks that [are] associated with transplantation,” he said. “These patients frequently have complicated pregnancies and [in] addition, these operations may take many hours and require risks to the patient.”
Leyland argued that while these results are interesting, a surgery like this one would be “extremely unlikely” in Canada.
“The amount of money that goes into doing this… it’s a very expensive procedure so obviously our healthcare system couldn’t possibly [cover it],” he continued. “We have enough trouble trying to provide a standard of care.”
He added a transplant itself is quite risky and complex, and there is also a risk of the body rejecting the organ.
“Is it ethical to put a patient at risk? When there are alternatives to achieving the same end?”
Surrogacy, for example, could have the same results.
Uterine transplants in North America
According to The Lancet, there have been 10 uterus transplants from deceased donors attempted in the past (in the U.S.Czech Republic and Turkey), but this was the first time there was a live birth.
In 2016, surgeons in Cleveland performed the U.S’s first uterus transplant on a 26-year-old woman from a deceased donor, a surgery which took nine hours. In 2017, another woman in Texas without a uterus gave birth at Baylor University Medical Center after a successful uterus transplant from a live donor.
The first baby to be born via a womb transplant was in Sweden in 2014, the BBC reported. The 36-year-old mother, also born without a uterus, received a donated womb from a friend.
“Our success is based on more than 10 years of intensive animal research and surgical training by our team and opens up the possibility of treating many young females worldwide that suffer from uterine infertility,” said Prof. Mats Brannstrom, who led the transplant team in 2014.
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