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DOI: 10.1055/s-0030-1268704
Uterus Transplantation: On the Edge
Publication History
Publication Date:
04 January 2011 (online)

ABSTRACT
Uterus transplantation for absolute uterus factor infertility is moving closer to human trials. The indication for uterus transplantation is evident as is its potential to ameliorate the social and personal burdens of these patients. The extensive collaborative research efforts between animal works, advancements in transplantation medicine, and immune suppression have culminated in demonstrating its apparent feasibility. As for the concerns regarding its risk, in perspective it is similar to other high-risk pregnancies. Moving uterus transplantation toward clinical applications obviously will require a continued commitment of research and support.
KEYWORDS
Uterus transplantation - uterus factor infertility - reproductive organ transplantation
REFERENCES
- 1 Cohen B M. Modern trends in reproductive organ transplantation advances and controversies. Fertil Steril. 2009; 91 (6) e4-e5 author reply e6
- 2 Scott J R, Pitkin R M, Yannone M E. Transplantation of the primate uterus. Surg Gynecol Obstet. 1971; 133 (3) 414-418
- 3 Cohen B M. Fallopian tube transplantation and its future. Clin Obstet Gynecol. 1980; 23 (4) 1275-1292
- 4 Fageeh W, Raffa H, Jabbad H, Marzouki A. Transplantation of the human uterus. Int J Gynaecol Obstet. 2002; 76 (3) 245-251
- 5 Louis K, Del Priore G. Uterine transplantation in humans: a new frontier. Int J Gynaecol Obstet. 2002; 76 243-244
- 6 Grady D. Medical first: A transplant of a uterus. New York Times. March 7, 2002 A1, A11
MissingFormLabel
- 7 Eraslan S, Hamernik R J, Hardy J D. Replantation of uterus and ovaries in dogs, with successful pregnancy. Arch Surg. 1966; 92 (1) 9-12
- 8 Morris R T. A case of heteroplastic ovarian grafting, following by pregnancy, and the delivery of a living child. Med Rec. 1906; 69 697-698
- 9 Silber S J, Grudzinskas G, Gosden R G. Successful pregnancy after microsurgical transplantation of an intact ovary. N Engl J Med. 2008; 359 (24) 2617-2618
- 10 Meirow D, Levron J, Eldar-Geva T et al. Pregnancy after transplantation of cryopreserved ovarian tissue in a patient with ovarian failure after chemotherapy. N Engl J Med. 2005; 353 (3) 318-321
- 11 Donnez J, Dolmans M M, Pirard C et al. Allograft of ovarian cortex between two genetically non-identical sisters: case report. Hum Reprod. 2007; 22 (10) 2653-2659
- 12 Ramirez E, Ramirez H, Nessetti Ramirez D, Nessetti M, Pillari V, Khatamee M. Modified uterine transplant procedure in the sheep model with successful pregnancy following embryo transfer. Fertil Steril. 2008; 90 S166-S167
- 13 Malanowska-Stega J, Schlatt S, Wagner R et al. Uterus allograft transplantation in non-human primates. J Reprod Sci. 2009; 16 (3 Suppl) 3A-66A
- 14 Nair A, Stega J, Smith J R, Del Priore G. Uterus transplant: evidence and ethics. Ann N Y Acad Sci. 2008; 1127 83-91
- 15 Osberg B. Bioethics without borders. Penn Bioethics J. 2 31
- 16 Inhorn M C. “He won't be my son”: Middle Eastern Muslim men's discourses of adoption and gamete donation. Med Anthropol Q. 2006; 20 (1) 94-120
- 17 Sharma B R. Forensic considerations of surrogacy—an overview. J Clin Forensic Med. 2006; 13 (2) 80-85
- 18 Clemetson L. Adopted in China seeking identity in America. New York Times. March 23, 2006
MissingFormLabel
- 19 Johnson D E. International adoption: what is fact, what is fiction, and what is the future?. Pediatr Clin North Am. 2005; 52 (5) 1221-1246
- 20 National Center for Health Statistics .Fertility, Family Planning, and Reproductive Health of U.S. Women: Data from the 2002
National Survey of Family Growth. Series 23, Number 25. Available at: http://www.cdc.gov/nchs/nvss.htm
MissingFormLabel
- 21 Stephen E H, Chandra A. Updated projections of infertility in the United States: 1995–2025. Fertil Steril. 1998; 70 (1) 30-34
- 22 Nair R, Feret M, Del Priore G, Malanowska-Stega J. Applicants for uterine transplantation: description of candidates. Fertil Steril. 2008; 90 (Suppl 1) S170
- 23 Malanowska-Stega J, Schlatt S, Wagner R, Nair A R, Feret M, Del Priore G. Primate uterus allograft transplant—one year later. Fertil Steril. 2008; 90 (Suppl 1) S169-S171
- 24 Del Priore G, Diflo T, Silber S, Grifo J A, Smith J R, Zhang J J. Ovary and uterine transplant: a successful rat model. J Soc Gynecol Investig. 2002; 9 (1, Suppl) 274a
- 25 Notices. Organ procurement and transplantation network. 42 Federal Regist. 2008; 73 (82) 11420-11422
- 26 Wranning C A, El-Akouri R R, Groth K, Mölne J, Parra A K, Brännström M. Rejection of the transplanted uterus is suppressed by cyclosporine A in a semi-allogeneic mouse model. Hum Reprod. 2007; 22 (2) 372-379
- 27 Smith J R, Boyle D, Ungar L, Corless D J, Del Priore G. Uterine transplant: a successful porcine model. [abstract] Fertil Steril. 2001; 76 (3S) s106
- 28 Wranning C A, Dahm-Kähler P, Mölne J, Nilsson U A, Enskog A, Brännström M. Transplantation of the uterus in the sheep: oxidative stress and reperfusion injury after short-time cold storage. Fertil Steril. 2008; 90 (3) 817-826
- 29 Dahm-Kähler P, Wranning C, Lundmark C et al. Transplantation of the uterus in sheep: methodology and early reperfusion events. J Obstet Gynaecol Res. 2008; 34 (5) 784-793
- 30 Malanowska-Stega J, Nair A R, Schlatt S, Miller W, Schron D, Del Priore G. Comparison of primate and human ovaries retrieved by transplant techniques vs. current clinical protocol. Fertil Steril. 2008; 90 S170
- 31 Del Priore G, Stega J, Sieunarine K, Ungar L, Smith J R. Human uterus retrieval from a multi-organ donor. Obstet Gynecol. 2007; 109 (1) 101-104
- 32 Wranning C A, El-Akouri R R, Lundmark C et al. Auto-transplantation of the uterus in the domestic pig (Sus scrofa): surgical technique and early reperfusion events. J Obstet Gynaecol Res. 2006; 32 (4) 358-367
- 33 Smith R, Hurst S, Kuzmin E, Noakes D, Corless D, DelPriore G. Successful uterine transplantation in the rabbit model. Fertil Steril. 2009; 92 (3) S60
- 34 Wranning C A, Dahm-Kähler P, Mölne J, Nilsson U A, Enskog A, Brännström M. Transplantation of the uterus in the sheep: oxidative stress and reperfusion injury after short-time cold storage. Fertil Steril. 2008; 90 (3) 817-826
- 35 Malanowska-Stega J, Schlatt S, Wagner R, Nair A R, Feret M, Del Priore G. Primate uterus allograft transplant—one year later. Fertil Steril. 2008; 90 (Suppl 1) S169-S170
- 36 Wranning C A, Akhi S N, Kurlberg G, Brännström M. Uterus transplantation in the rat: model development, surgical learning and morphological evaluation of healing. Acta Obstet Gynecol Scand. 2008; 87 (11) 1239-1247
- 37 Racho El-Akouri R, Kurlberg G, Brännström M. Successful uterine transplantation in the mouse: pregnancy and post-natal development of offspring. Hum Reprod. 2003; 18 (10) 2018-2023
- 38 Del Priore G, Schlatt S, Malanowska-Stega J. Uterus transplant techniques in primates: 10 years' experience. Exp Clin Transplant. 2008; 6 (1) 87-94
- 39 Confino E, Vermesh M, Thomas Jr W, Gleicher N. Non-vascular transplantation of the rabbit uterus. Int J Gynaecol Obstet. 1986; 24 (4) 321-325
- 40 Hammadieh N, Coomarasamy A, Ola B, Papaioannou S, Afnan M, Sharif K. Ultrasound-guided hydrosalpinx aspiration during oocyte collection improves pregnancy outcome in IVF: a randomized controlled trial. Hum Reprod. 2008; 23 (5) 1113-1117
- 41 Gordon C R, Siemionow M. Requirements for the development of a hand transplantation program. Ann Plast Surg. 2009; 63 (3) 262-273
- 42 Sieunarine K, Boyle D CM, Corless D J et al. Pelvic vascular prospects for uterine transplantation. Int Surg. 2006; 91 (4) 217-222
- 43 Sieunarine K, Hakim N S, Corless D J et al. Is it feasible to use a large vessel patch with a uterine allograft en bloc for uterine transplantation?. Int Surg. 2005; 90 (5) 257-261
- 44 Ungár L, Smith J R, Pálfalvi L, Del Priore G. Abdominal radical trachelectomy during pregnancy to preserve pregnancy and fertility. Obstet Gynecol. 2006; 108 (3 Pt 2) 811-814
- 45 Smith J R, Boyle D CM, Corless D J et al. Abdominal trachelectomy. A new surgical technique for the conservative management of cervical carcinoma. Br J Gynaecol Obstet. 1997; 104 1196-1200
- 46 Guner M, Pirat A, Zeyneloglu P et al. Effect of the interval between organ donor brain death and organ harvesting on kidney graft function after transplantation. Transplant Proc. 2007; 39 (4) 837-841
- 47 Zeevi A, Girnita A, Duquesnoy R. HLA antibody analysis: sensitivity, specificity, and clinical significance in solid organ transplantation. Immunol Res. 2006; 36 (1-3) 255-264
- 48 Waid T H, Thompson J S, Siemionow M, Brown S A. T10B9 monoclonal antibody: a short-acting nonstimulating monoclonal antibody that spares gammadelta T-cells and treats and prevents cellular rejection. Drug Des Devel Ther. 2009; 3 205-212
- 49 Kawai T, Cosimi A B, Spitzer T R et al. HLA-mismatched renal transplantation without maintenance immunosuppression. N Engl J Med. 2008; 358 (4) 353-361
- 50 Armenti V T, Daller J A, Constantinescu S et al. Report from the National Transplantation Pregnancy Registry: outcomes of pregnancy after transplantation. Clin Transpl. 2006; 57-70
Giuseppe Del PrioreM.D. M.P.H.
Indiana University, Simon Cancer Center
535 Barnhill Drive, Room RT 433, Indianapolis, IN 46202
Email: gdelprio@IUPUI.edu