World's first baby born via womb transplant from dead donor

A medical team in São Paulo with a baby born via a uterine transplant.									Divulgação

A medical team in São Paulo with a baby born via a uterine transplant. Divulgação

The details of the first baby born following a uterus transplantation from a deceased donor were reported in a case study from Brazil, published in The Lancet.

The uterus was removed from the donor and then transplanted into the recipient in surgery lasting more than 10 hours.

The donor was 45 years old when she died of a stroke and donated her uterus. In this case, a cesarean section was performed for birth at 35 weeks gestation, and along with the delivery of an nearly 6 pound healthy baby girl, the uterus was also removed. Almost a year later, mother and baby are both healthy.

The report concludes that the results establish proof-of-concept for "treating uterine infertility by transplantation from a deceased donor, opening a path to a healthy pregnancy for all women with uterine factor infertility, without the need of living donors or live donor surgery".

The authors say their version of the procedure isn't meant to replace the possibility of using a living donor, but rather to give women with uterine problems another option. The first of these occurred in Sweden in 2013 and since then, 11 babies have been born after similar procedures, according to the Lancet.

Part of the challenge in transplanting a uterus from a deceased donor is that the process - obtaining an organ, matching it to a recipient based on blood type and other qualities, and completing the operation - can take time. "However, the need for a live donor is a major limitation as donors are rare, typically being willing and eligible family members or close friends".

The baby girl is healthy and developing normally, according to Dani Ejzenberg, the doctor at the University of Sao Paulo in Brazil who led the transplant team.

"There are still lots of things we don't understand about pregnancies, like how embryos implant", said Cesar Diaz, who co-authored an accompanying commentary in the journal.

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No. In order to keep the uterus after birth, the mother would have to continue taking immune system suppression medications which can pose risks. Flyckt and her colleagues in Cleveland have also performed two transplants from deceased donors.

The use of a deceased donor is a significant achievement that could greatly increase access to the procedure, said Stefan Tullius, chief of transplant surgery at Brigham and Women's Hospital in Boston who has participated in living donor uterus transplant surgery.

Women who would be candidates for a uterus transplant would have absolute uterine infertility, meaning they don't have a uterus or that it is too damaged to support a pregnancy. Uterine transplants can sidestep these issues and allow women who otherwise wouldn't be able to have the chance to carry their own pregnancies.

With this recent success comes not just the promise of greater access to donor organs, but vital information on what a transplanted uterus requires to successfully carry an embryo to full term.

Researchers point out that the latest landmark birth may create more options for women in the future, since live donors can be hard to find.

Since the recipient's ovaries were fine, she underwent one in-vitro fertilisation (IVF) cycle four months before transplant, Ejzenberg said.

Some who were born without a uterus, other had unexplained malformations, of sustained damaged during childbirth or infection.

She said just one of the consequences of a such a procedure is the potential rupturing of the uterus, which could have had catastrophic effects for the mother and the child.

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