First baby born after deceased womb transplant in Brazil

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

This isn't the first baby born to a woman with a uterine transplant-several have been born in Sweden, the US, and Brazil to women who received uterine transplants from live donors.

"This can be an important limitation when you don't have a close friend or a relative who can donate their uterus", said Doctor Wellington Andraus, the head transplant surgeon involved in the procedure.

The baby was delivered by way of a cesarean section on December 15, 2017 at around 36 weeks into the pregnancy.

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. Seven months after the transplant, doctors transferred an embryo made via in-vitro fertilization from the woman's egg and her husband's sperm into her womb.

The woman received the transplant in 2016 from a 45-year-old woman who had three children and died of a stroke.

Dr Dani Ejzenberg, from Hospital das Clínicas in São Paulo, said: "The first uterus transplants from live donors were a medical milestone, creating the possibility of childbirth for many infertile women with access to suitable donors and the needed medical facilities".

"The number of people willing and committed to donate organs upon their own death are far larger than those of live donors, offering a much wider potential donor population", he said in a statement.

Uterine transplants from living donors have succeeded; at least 11 babies have been born this way since 2013.

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Doctors also removed the transplanted uterus during her C-section in order to take the mother off immunosuppressant medication required for maintaining a transplanted organ. A year later, doctors say the mother and child are healthy.

While there have been several cases of successful deliveries following uterine transplants from family and friends, it was once believed that a transplant from a deceased donor was not possible.

The uterus from the deceased donor was implanted during a 10-hour operation. Flyckt and her colleagues in Cleveland have also performed two transplants from deceased donors.

In a surgery lasting 10.5 hours, the uterus was removed from the donor and transplanted into the recipient, where it was connected to the recipient's veins and arteries as well as her ligaments and vaginal canals.

In the end, they held off an additional month after tests suggested the lining of the donor uterus wasn't quite thick enough to support implantation.

Although uterus transplants are a growing area of medicine, they remain highly experimental and are very hard surgeries to complete. But researchers said that if transplant teams can reliably use uteruses from deceased donors, it could expand the availability of organs and reduce living donors' risks during surgery to remove the uterus.

"In an expanding field such as uterus transplantation, the role of collaborative networks and societies such as the International Society of Uterus Transplantation or new interest groups in already existing scientific societies will be crucial". And it's possible that patients won't need as many immunosuppressants as they now receive to stave off organ rejection. It's a rare genetic condition, affecting about 4500 women worldwide, in which they are born without a uterus.

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