Modified human uterus transplantation of exclusive using ovarian veins for venous drainage: the first report of surgically successful robotic-assisted uterus procurement and follow-up for 12 month

We discuss the 12-month results of the first human uterus transplantation case using ovarian veins for venous drainage and using robot-assisted uterine retrieval.

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Volume 108, Issue 2, Pages 346–356.e1

Authors:

Li Wei, M.D., Ph.D., Tao Xue, M.D., Ph.D., Kai-Shan Tao, M.D., Ph.D., Geng Zhang, M.D., Ph.D., Guang-Yue Zhao, M.D., Ph.D., Shi-Qiang Yu, M.D., Ph.D., Liang Cheng, M.D., Ph.D., Zhao-Xu Yang, M.D., Ph.D., Min-Juan Zheng, M.D., Ph.D., Fei Li, M.D., Ph.D., Qiong wang, M.D., Ph.D., Ying han, M.D., Ph.D., Yong-Quan Shi, M.D., Ph.D., Hai-Long Dong, M.D., Ph.D., Zhi-Hong Lu, M.D., Ph.D., Yun Wang, M.D., Ph.D., Hong Yang, M.D., Ph.D., Xiang-Dong Ma, M.D., Ph.D., Shu-Juan Liu, M.D., Ph.D., Hai-Xia Liu, M.D., Ph.D., Li-Ze Xiong, M.D., Ph.D., Bi-Liang Chen, M.D., Ph.D.

Abstract:

Objective

To report the 12-month results of the first human uterus transplantation case using robot-assisted uterine retrieval. This type of transplantation may become a treatment for permanent uterine factor infertility.

Design

Case study.

Setting

University hospital.

Patient(s)

A 22-year-old woman with complete müllerian agenesis who underwent a previous surgery for vaginal reconstruction. The live uterine donor was her mother.

Intervention(s)

The uterus transplantation procedure consisted of robot-assisted uterine procurement, orthotopic replacement and fixation of the retrieved uterus, revascularization, and end-to-side anastomoses of bilateral hypogastric arteries and ovarian-uterine vein to the bilateral external iliac arteries and veins.

Main Outcome Measure(s)

Data from preoperative investigations, surgery, and follow-up (12 months).

Result(s)

The duration of the donor and recipient surgeries were 6 and 8 hours, 50 minutes, respectively. No immediate perioperative complications occurred in the recipient or donor. The recipient experienced menarche 40 days after transplant surgery, and she has had 12 menstrual cycles since the surgery. No rejection episodes occurred in the recipient.

Conclusion(s)

These results demonstrate the feasibility of live-donor uterine transplantation with a low-dose immunosuppressive protocol and the role of DaVinci robotic assistance during human uterine procurement.

Clinical Trial Registration Number

XJZT12Z06.


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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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