Baby born via uterus trans­planted from dead donor

The Phnom Penh Post - - WORLD -

IN A med­i­cal first, a mother who re­ceived a uterus trans­plant from a dead donor gave birth to a healthy baby, re­searchers re­ported on Wed­nes­day.

The break­through op­er­a­tion, per­formed in Septem­ber 2016 in Sao Paulo, Brazil, shows that such trans­plants are fea­si­ble and could help thou­sands of women un­able to have chil­dren due to uter­ine prob­lems, ac­cord­ing to a study pub­lished in the Lancet.

The baby girl was born in De­cem­ber last year, the med­i­cal jour­nal added.

Un­til re­cently, the only op­tions avail­able to women with so-called uter­ine in­fer­til­ity were adop­tion or the ser­vices of a sur­ro­gate mother.

The first suc­cess­ful child­birth fol­low­ing uter­ine trans­plant from a liv­ing donor took place in 2014 in Swe­den, and there have been 10 oth­ers since then.

But there are far more women in need of trans­plants than there are po­ten­tial live donors, so doc­tors wanted to find out if the pro­ce­dure could work us­ing the uterus of a woman who had died.

Ten at­tempts were made – in the US, the Czech Repub­lic and Tur­key – be­fore the suc­cess re­ported on Wed­nes­day.

In­fer­til­ity af­fects 10 to 15 per cent of cou­ples.

Of this group, one in 500 women have prob­lems with their uterus – due, for ex­am­ple, to in­fec­tion – that pre­vent them from be­com­ing preg­nant and car­ry­ing a child to term.

“Our re­sults pro­vide a proof-of-con­cept for a new op­tion for women with uter­ine in­fer­til­ity,” said Dani Ejzen­berg, a doc­tor at the teach­ing hospi­tal of the Univer­sity of Sao Paulo.

He de­scribed the pro­ce­dure as a “med­i­cal mile­stone”.

“The num­ber of peo­ple will­ing and com­mit­ted to do­nate or­gans upon their own death are far larger than those of live donors, of­fer­ing a much wider po­ten­tial donor pop­u­la­tion,” he said in a state­ment.

The 32-year-old re­cip­i­ent was born with­out a uterus.

Four months be­fore the trans­plant, she had in-vitro fer­til­i­sa­tion re­sult­ing in eight fer­tilised eggs, which were pre­served through freez­ing.

The donor was a 45-year-old woman who died from a stroke.

Her uterus was re­moved and trans- planted in surgery that lasted more than 10 hours. The sur­gi­cal team had to con­nect the donor’s uterus with the veins, ar­ter­ies, lig­a­ments and vagi­nal canal of the re­cip­i­ent.

To pre­vent her body from re­ject­ing the new or­gan, the woman was given f ive dif fer­ent drugs, a long wit h an­timi­cro­bia ls, anti-blood clot­ting treat­ments, and aspirin.

Af­ter five months, the uterus showed no sign of re­jec­tion, ul­tra­sound scans were nor­mal and the woman was men­stru­at­ing reg­u­larly.

The fer­tilised eggs were im­planted af­ter seven months. Ten days later, doc­tors de­liv­ered the good news – she was preg­nant.

Be­sides a mi­nor kid­ney in­fec­tion – treated with an­tibi­otics – dur­ing the 32nd week, the preg­nancy was nor­mal. Af­ter nearly 36 weeks a baby girl weigh­ing 2.5kg was de­liv­ered via cae­sarean sec­tion.

Mother and baby left the hospi­tal three days later.

The trans­planted uterus was re­moved dur­ing the C-sec­tion, al­low­ing the woman to stop tak­ing the im­muno­sup­pres­sive drugs.

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

“We must c on g r a t u l a t e t he aut hors,” com­mented Dr Srdja n Saso, an hon­o­rar y clin­i­cal lec­turer in ob­stet r ics a nd g y nae­colog y at Im­pe­rial Col­lege Lon­don.

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