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Doctors Perform 1st U.S. Living-Donor Uterine Transplant

Infertility procedure was tried in 4 women but has remained successful in only one, Texas team says

WEDNESDAY, Oct. 5, 2016 (HealthDay News) -- A team of doctors in Dallas is "cautiously optimistic" of success in what would be the first living-donor uterine transplant in the United States.

Doctors at Baylor University Medical Center said Wednesday that they performed four of the transplants in September, but only one has proven successful.

"During the past three weeks since the first surgery, we performed routine follow-up testing as part of the trial protocol on all four patients," Baylor said in a statement. "In three patients, we determined after several tests the transplanted organs were not receiving viable blood flow and the uteri were removed. Those patients are now doing well and will soon be back to normal activity."

However, "The fourth patient's follow-up tests currently indicate a much different result," Baylor said. "Her tests are showing good blood flow to the uterus. There are also no signs of rejection or infection at this time. We are cautiously optimistic that she could ultimately become the first uterine transplant recipient in the U.S. to make it to the milestone of uterine functionality."

According to the medical center, the surgeries were performed in Dallas between Sept. 14-22 after two years of preparation and an extensive review of all 16 previous uterine transplants performed worldwide.

The Baylor team was assisted by Swedish surgeons whose past uterine transplants have led to five births and who are widely regarded as the world's experts in this type of transplant.

No other details about the procedure or the patients were released.

Women who are candidates for a uterus -- or womb -- transplant are born without one.

Patients who are candidates for such a transplant first must undergo in vitro fertilization to retrieve and fertilize their eggs and produce embryos that can be frozen until doctors are ready to try a pregnancy. A transplanted uterus isn't permanent because the recipient must take powerful drugs to prevent organ rejection, and such drugs pose long-term health risks. So, the transplanted womb would be removed after one or two successful pregnancies, the Associated Press reported.

This is not the first time a uterine transplant has been attempted in the United States. On Feb. 24, a team at the Cleveland Clinic performed a uterine transplant for a woman in her mid-20s who had adopted three children because she was born without a uterus and was unable to give birth to her own child.

Unlike the Dallas procedures involving live donors, the Cleveland case involved a donated uterus from a 30-year-old woman who had died suddenly.

Unfortunately, the transplanted organ had to be removed on March 9 after complications from a common yeast infection, which "compromised the blood supply to the uterus," according to a statement from the Cleveland Clinic.

One obstetrician/gynecologist said the high number of failed uterine transplants suggests the procedure is still a risky one.

"This is a promising procedure for women without a uterus who wish to carry their own pregnancies," said Dr. Anthony Vintzileos, who heads the department of obstetrics and gynecology at Winthrop-University Hospital in Mineola, N.Y. "However, we have a very long way to go before this operation becomes widely available and successful."

Uterine transplant failure is always a possibility, the Baylor doctors said in the statement.

The three transplants that failed will provide valuable information and recommendations "to change the current protocols in operative and postoperative management of uterine transplant patients with specific attention to the thickness of the uterine veins," the statement said.

The Baylor team said it would share everything it learns about uterine transplants with researchers worldwide.

More information

The Cleveland Clinic has more on uterine transplants.

SOURCES: Anthony Vintzileos, M.D., chair, department of obstetrics and gynecology, Winthrop-University Hospital, Mineola, N.Y.; Baylor University Medical Center, news release, Oct. 5, 2016; Associated Press

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