Woman with a transplanted uterus gives birth, the first in the US UU – tech2.org

Woman with a transplanted uterus gives birth, the first in the US UU



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Dr. Liza Johannesson, a uterus transplant surgeon who left the Swedish team to join the Baylor group, said the birth in Dallas was particularly important because it showed success was not limited to the hospital in Gothenburg.

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The mother of the baby was born without a uterus The baby was delivered by a scheduled cesarean section.

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Baylor University Medical Center, through the Associated Press

"In order for the field to grow and expand and have the procedure extended to more women, it has to reproduce," he said, adding that a few hours after the Baylor's announcement, women's advocacy groups with uterine infertility from around the world contacted her to express their excitement at the news.

"It was a very exciting birth," said Dr. Johannesson. "I've seen so many births and I've given birth to so many babies, but this one was very special."

At Baylor, eight women underwent transplants, including the new mother, in a clinical trial designed to include 10 patients. One recipient is pregnant and two others, one of whom received a transplant from a deceased donor, are trying to conceive. Four other transplants failed after surgery, and the organs had to be removed, said Dr. Giuliano Testa, principal investigator of the research project and surgical chief of abdominal transplant.

"We had a very difficult start, and then we hit the right path," Dr. Testa said in a telephone interview. "The one who paid in a certain way was the first three women, I feel very grateful for their contribution, more than I can express."

Both Dr. Johannesson and Dr. Testa said that a large part of their motivation came from knowing patients and coming to understand how devastated they were to discover they could not have children.

Dr. Testa said: "I think many men will never fully understand this, to understand the desire of these women to be mothers." What moved us all was to see the mother holding her baby, when they said: "Never will you have? "

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Transplants are now experimental and much of the cost is covered by research funds. But they are expensive, and if they become part of medical practice, they will probably cost hundreds of thousands of dollars. It is not clear if insurers will pay, and Dr. Testa recognized that many women who want surgery will not be able to afford it.

Another hospital, the Cleveland Clinic, performed the first uterine transplant in the United States in February 2016, but failed after two weeks due to an infection that caused life-threatening hemorrhage and required emergency surgery to remove the organ. The clinic stopped its program for a prolonged period, but has restarted it and has patients waiting for transplants, said a spokeswoman, Victoria Vinci.

The woman who gave birth at Baylor was the fourth to receive a transplant there in September 2016.

The process is complicated and has considerable risks for both recipients and donors. Donors undergo a five-hour operation that is more complex and removes more tissue than a standard hysterectomy to remove the uterus. Transplant surgery is also difficult, in a way comparable to a liver transplant, Dr. Testa said.

Recipients face the risks of surgery and anti-rejection medications for a transplant that, unlike someone with heart or liver failure, it is not necessary to save their lives. Their pregnancies are considered high risk, and babies should be delivered by caesarean section to avoid putting too much strain on the transplanted uterus. So far, all births have occurred a little before the 40 normal weeks of gestation, at 32 to 36 weeks.

Women who have transplants can not conceive naturally, because their ovaries are not connected to the uterus, so there is no way for an egg to enter there. Instead, they need in vitro fertilization. Before the transplant, women receive hormonal treatments to make their ovaries release multiple ovules, which are then harvested, fertilized and frozen.

Once the woman has fully recovered from the surgery and started menstruating, the ovules can be implanted in the uterus, one at a time, until she becomes pregnant.

In Sweden, doctors waited a year after the transplant before trying to start a pregnancy, to allow women time to heal. At Baylor, the team moved much faster and began trying to fecundate the women a few months after the surgery, shortly after they started menstruating.

Dr. Testa said it was his idea to start the pregnancies before, because the women were young and healthy, and they did not need a year to recover from the surgery. He maintained that the waiting time kept them in anti-rejection drugs, which have significant side effects, for longer than necessary.

"We were shorter," he said. "I think we were right."

He and Dr. Johannesson said that the Swedish team and other centers planning the transplants had also begun to consider shortening the wait.

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