Uterus Transplantation: A 50-Year Journey

Abstract

This paper provides an analysis of the last 50 years of uterus transplantation (UTx). Animal research on UTx began in the 1960s, aiming to solve tubal factor infertility. The success of in vitro fertilization shifted the focus onto uterine factor infertility. Early research in small and large animals improved following the advent of immunosuppression and established the uterus' ability to tolerate cold ischemia and to function following vessel reanastamosis. Upon the achievement of the first live birth following UTx in 2014, human research has started to focus on reducing donor morbidity, optimal immunosuppression regimes, and the development of deceased donor UTx programmes.

A multi-institutional study of renal outcomes and renal-related pregnancy outcomes in uterus transplant recipients

“…In the wake of the world's first successful live birth in 2014, 1 uterus transplantation has rapidly expanded throughout the world, with 34 transplants and 22 live births in the United States alone. 2,3 For all of its success, however, pregnancy after a uterus transplant remains complex, and pregnancy complications such as pre-eclampsia (PE) have been reported. Initial single center reports 2,4,5 suggested that PE was observed in 8-17.6% of patients, and this high rate of PE has largely been attributed to immunosuppression given the increased prevalence of PE in solid organ transplant recipients.…”

“…Uterus transplantation has emerged as a highly effective treatment option for uterine factor infertility (UFI). In the wake of the world's first successful live birth in 2014, 1 uterus transplantation has rapidly expanded throughout the world, with 34 transplants and 22 live births in the United States alone 2,3 . For all of its success, however, pregnancy after a uterus transplant remains complex, and pregnancy complications such as pre‐eclampsia (PE) have been reported.…”

A Multi-Institutional Report of Intermediate-Term Kidney Outcomes in Uterus Transplant Recipients

“…Globally, the number of UTx recipients is increasing. 1 , 2 , 3 Many recipients have Mayer-Rokitansky-Kuster-Hauser syndrome, which may include unilateral kidney agenesis in addition to a congenitally absent uterus and vaginal aplasia. 4 Therefore, kidney dysfunction is a potential complication of UTx.…”