Deceased donor uterine transplantation

In this video we present a uterine transplantation performed on a patient with Mayer-Rokitansky- Kuster-Hauser syndrome, using a uterus from a deceased donor.

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Volume 107, Issue 3, Page e13

Authors:

Rebecca Flyckt, M.D., Alexander Kotlyar, M.D., Sara Arian, M.D., Bijan Eghtesad, M.D., Tommaso Falcone, M.D., Andreas Tzakis, M.D.

Abstract:

Objective

To share our experience in performing the first-ever deceased-donor uterine transplant in the United States.

Design

This video uses an animation and footage from a uterine transplantation procedure to review the steps and techniques involved in performing a uterine transplant.

Setting

Academic, multisite medical center.

Patient(s)

A reproductive-age patient with Mayer-Rokitansky-Kuster-Hauser syndrome.

Intervention(s)

Transplantation of a viable uterus from a deceased donor.

Main Outcome Measure(s)

Assessment of posttransplantation uterine graft viability.

Result(s)

This video article describes the essential steps in the uterine transplant process, including selecting an appropriate donor with no history of infertility or uterine malformations. Furthermore, a deceased donor should exhibit brain death but not cardiac death. We also review our inclusion criteria for suitable recipients. In this video we outline the key steps in a uterine transplantation procedure and demonstrate footage from an actual transplant procedure. These steps include establishing bilateral end-to-side vascular anastomoses between the donor uterine artery and vein and the recipient's external iliac vessels. Once this has been completed and reperfusion noted of the donor uterus, connection to the recipient vaginal cuff is then performed.

Conclusion(s)

Uterine transplantation, although currently experimental, has gained the potential to become the first true treatment for uterine factor infertility. This procedure can become a promising option for the approximately 1.5 million women worldwide for whom pregnancy is not possible because of the absence of the uterus or presence of a nonfunctional uterus. Deceased donor uterine transplantation will further serve to broaden accessibility for this procedure.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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