World's first baby born via womb transplant from dead donor

Henrietta Strickland
December 5, 2018

The first baby born after a live donor womb transplant was in Sweden in 2013.

"In an expanding field such as uterus transplantation, the role of collaborative networks and societies such as the International Society of Uterus Transplantation or new interest groups in already existing scientific societies will be crucial".

The Cleveland program is continuing to use deceased donors.

The patient was a 32-year-old woman with Mayer-Rokitansky-K├╝ster-Hauser (MRKH) syndrome, a rare genetic disorder that causes the vagina or uterus to either under-develop or not develop at all.

The team said the success meant that women for whom surrogacy or adoption was previously the only option for starting a family might soon have another path they could choose.

The woman became pregnant through in vitro fertilization seven months after the transplant.

The donor was a 45-year-old woman who died of subarachnoid haemorrhage - a type of stroke involving bleeding on the surface of the brain.

The woman's pregnancy was normal, and doctors performed a Caesarean section on December 15, 2017, after about 36 weeks (a full term is about 40 weeks).

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.

At age seven months and 12 days - when the manuscript reporting the findings was submitted for publication - the baby was breastfeeding and weighed 7.2 kilogrammes.

"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", he said. Last year, doctors at Baylor University Medical Center in Dallas delivered the first USA baby to be carried in a transplanted uterus.

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

She stayed in intensive care for two days after the surgery and then spent six more on a specialised transplant ward. Flyckt and her colleagues in Cleveland have also performed two transplants from deceased donors.

Shortly thereafter, surgeons performed a uterus transplant, connecting the donor organ to the recipient's veins, arteries, ligaments and vaginal canals during a surgery that lasted more than 10 hours. In the first, the uterus had to be removed from the recipient after an infection occurred; Flyckt said she couldn't say where things stood with the second case other than that the recipient was doing well. The uterus can only survive away from a blood supply for so long.

Ejzenberg said that finding a living donor could also be hard, while coordinating operations was logistically challenging.

The researchers in Brazil reported that the uterus was ischemic - meaning, off a blood supply - for nearly eight hours, essentially double the reported time from any of the living donor transplants.

"This actually tells us that the uterus is very resilient", Flyckt said.

The donated uterus was removed during the C-section and the woman's wound healed well, the researchers say. The recipient tolerated the transplant relatively well thanks to immunosuppression drugs, other treatments and constant monitoring.

The oldest child born via uterine transplant - a boy - had just had his fourth birthday. Though it's never been done before, Ejzenberg says "theoretically, it may be possible" to someday use such discarded organs for secondary transplants.

While researchers in countries including Sweden and the U.S. have previously succeeded in transplanting wombs from living donors into women who have gone on to give birth, experts said the latest development was a significant advance.

"They should promote education and guidance so that the groups performing uterus transplantation for the first time can benefit from the experience of the pioneers". "It's a landmark birth".

Other reports by Click Lancashire

Discuss This Article