Skip to main content
SpringerLink
Log in
Book cover

Textbook of Oncofertility Research and Practice pp 395–400Cite as

Uterus Transplantation

  • Chapter
  • First Online:

Abstract

Prior to the development of uterus transplantation (UTx), absolute uterine factor infertility was untreatable. The original idea was inspired by a patient with cervical cancer who required a hysterectomy but asked about uterus transplant as she desired gestational motherhood. This resulted in over a decade of extensive animal-based research, from rodents to non-human primates. Development was performed, following the IDEAL recommendations for introduction of surgical innovations. The Swedish trial (2013) was the first to establish proof of concept, with eight babies born, all from live donor transplants. At the time of this writing, two other countries have achieved live births following UTx. In the United States, there have been two births, both from live donor transplants. Brazil reported the first live birth using a deceased donor. It should be emphasized that UTx should only be considered in a woman in whom risk of recurrent malignancy is considered negligible.

Financial support and sponsorship: Jane and Dan Olsson Foundation for Science

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Brännström M, Johannesson L, Bokström H, et al. Live birth after uterus transplantation. Lancet. 2015;385:607–16.

    Article  Google Scholar 

  2. Sieunarine K, Zakaria FBP, Boyle DCM, et al. Possibilities for fertility restoration: a new surgical technique. Int Surg. 2005;90:249–56.

    PubMed  Google Scholar 

  3. McCulloch P, Altman DG, Campbell WB, et al. No surgical innovation without evaluation: the IDEAL recommendations. Lancet. 2009;374:1105–12.

    Article  Google Scholar 

  4. Racho El-Akouri R, Kurlberg G, Brännström M. Successful uterine transplantation in the mouse: pregnancy and postnatal development of offspring. Hum Reprod. 2003;18:2018–23.

    Article  Google Scholar 

  5. Wranning CA, Akhi SN, Diaz-Garcia C, et al. Pregnancy after syngeneic uterus transplantation and spontaneous mating in the rat. Hum Reprod. 2011;26:553–8.

    Article  Google Scholar 

  6. Diaz-Garcia C, Akhi SN, Wallin A, et al. First report on fertility after allogeneic uterus transplantation. Acta Obstet Gynecol Scand. 2010;89:1491–4.

    Article  Google Scholar 

  7. Diaz-Garcia C, Johannesson L, Shao R, et al. Pregnancy after allogeneic uterus transplantation in the rat: perinatal outcome and growth trajectory. Fertil Steril. 2014;102:1545–52.

    Article  Google Scholar 

  8. Wranning CA, Marcickiewicz J, Enskog A, et al. Fertility after autologous ovine uterine-tubal-ovarian transplantation by vascular anastomosis to the external iliac vessels. Hum Reprod. 2010;25:1973–9.

    Article  CAS  Google Scholar 

  9. Ramirez ER, Ramirez-Nessetti DK, Nessetti MB, et al. Pregnancy and outcome of uterine allotransplantation and assisted reproduction in sheep. J Minim Invasive Gynecol. 2011;18:238–45.

    Article  Google Scholar 

  10. Mihara M, Kisu I, Hara H, et al. Uterine autotransplantation in cynomolgus macaques: the first case of pregnancy and delivery. Hum Reprod. 2012;27:2332–40.

    Article  Google Scholar 

  11. Brännström M, Johannesson L, Dahm-Kähler P, et al. The first clinical uterus transplantation trial: a six months report. Fertil Steril. 2014;101:1228–36.

    Article  Google Scholar 

  12. Kvarnström N, Järvholm S, Johannesson L, et al. Live uterus donors of the initial observational study of uterus transplantation – psychological and medical follow-up until 1 year after surgery in the 9 cases. Transplantation. 2017;101:664–70.

    Article  Google Scholar 

  13. Brännström M, Bokström M, Dahm-Kähler P, et al. One uterus bridging three generations; first live birth after mother-to-daughter uterus transplantation. Fertil Steril. 2016;107:261–6.

    Article  Google Scholar 

  14. Testa G, Koon EC, Johannesson L, et al. Living donor uterus transplantation: a single center’s observations and lessons learned from early setbacks to technical success. Am J Transplant. 2017;17:2901–10.

    Article  CAS  Google Scholar 

  15. Ejzenberg D, Andraus W, Baratelli Carelli Mendes LR, et al. Livebirth after uterus transplantation from a deceased donor in a recipient with uterine infertility. Lancet. 2019;392(10165):2697–704.

    Google Scholar 

  16. Acuna SA, Huang JW, Daly C, et al. Outcomes of solid organ transplant recipients with preexisting malignancies in remission: a systematic review and meta-analysis. Transplantation. 2017;101(3):471–81.

    Article  Google Scholar 

  17. Brattström C, Granath F, Edgren G, et al. Overall and cause-specific mortality in transplant recipients with a pretransplantation cancer history. Transplantation. 2013;96(3):297–305.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg and Stockholm IVF, Stockholm, Sweden

    Mats Brännström

  2. Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden

    Mats Brännström

  3. School of Medicine, Western Sydney University, Sydney, NSW, Australia

    Jana Pittman

Authors
  1. Mats Brännström
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jana Pittman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mats Brännström .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Northwestern University , Chicago, IL, USA

    Teresa K. Woodruff

  2. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA

    Divya K. Shah

  3. Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA

    Wendy S. Vitek

Review Questions and Answers

Review Questions and Answers

  1. Q1.

    How many women are estimated to have absolute uterine factor infertility in a population of 100 million?

  2. A1.

    20,000

  3. Q2.

    Which main vessels in the recipient were the donor’s uterine pedicles anastomosed to?

  4. A2.

    Recipient’s external iliac vessels

  5. Q3.

    Which immunosuppressive agents were used as maintenance in the first 8 months after the uterine transplant?

  6. A3.

    Tacrolimus and mycophenolate mofetil

  7. Q4.

    How long should a woman wait post malignancy before considering a uterus transplant?

  8. A4.

    Minimum 5 years after hysterectomy and treatment has been completed.

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Brännström, M., Pittman, J. (2019). Uterus Transplantation. In: Woodruff, T., Shah, D., Vitek, W. (eds) Textbook of Oncofertility Research and Practice. Springer, Cham. https://doi.org/10.1007/978-3-030-02868-8_34

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-02868-8_34

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-02867-1

  • Online ISBN: 978-3-030-02868-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation