First clinical uterus transplantation trial: A six-month report

Mats Brännström, Liza Johannesson, Pernilla Dahm-Kähler, Anders Enskog, Johan Mölne, Niclas Kvarnström, Cesar Diaz-Garcia, Ash Hanafy, Cecilia Lundmark, Janusz Marcickiewicz, Markus Gäbel, Klaus Groth, Randa Akouri, Saskia Eklind, Jan Holgersson, Andreas Tzakis, Michael Olausson

Research output: Contribution to journalArticleResearchpeer-review

175 Citations (Scopus)

Abstract

OBJECTIVE: To report the 6-month results of the first clinical uterus transplantation (UTx) trial. This type of transplantation may become a treatment of absolute uterine-factor infertility (AUFI).

DESIGN: Prospective observational study.

SETTING: University hospital.

PATIENT(S): Nine AUFI women and their live uterine donors, the majority being mothers.

INTERVENTION(S): Live-donor UTx and low-dose induction immunosuppression.

MAIN OUTCOME MEASURE(S): Data from preoperative investigations, surgery and follow-up for 6 months.

RESULT(S): Durations of donor and recipient surgery ranged from 10 to 13 hours and from 4 to 6 hours, respectively. No immediate perioperative complications occurred in any of the recipients. After 6 months, seven uteri remained viable with regular menses. Mild rejection episodes occurred in four of these patients. These rejection episodes were effectively reversed by corticosteroid boluses. The two graft losses were because of acute bilateral thrombotic uterine artery occlusions and persistent intrauterine infection.

CONCLUSION(S): The results demonstrate the feasibility of live-donor UTx with a low-dose immunosuppressive protocol.

CLINICAL TRIAL REGISTRATION NUMBER: NCT01844362.

Original languageEnglish
Pages (from-to)1228-1236
Number of pages9
JournalFertility and Sterility
Volume101
Issue number5
DOIs
Publication statusPublished - May 2014
Externally publishedYes

Fingerprint

Uterus
Transplantation
Tissue Donors
Infertility
Uterine Artery
Menstruation
Immunosuppressive Agents
Immunosuppression
Observational Studies
Adrenal Cortex Hormones
Mothers
Clinical Trials
Prospective Studies
Transplants
Infection
Rejection (Psychology)
Therapeutics

Cite this

Brännström, M., Johannesson, L., Dahm-Kähler, P., Enskog, A., Mölne, J., Kvarnström, N., ... Olausson, M. (2014). First clinical uterus transplantation trial: A six-month report. Fertility and Sterility, 101(5), 1228-1236. https://doi.org/10.1016/j.fertnstert.2014.02.024
Brännström, Mats ; Johannesson, Liza ; Dahm-Kähler, Pernilla ; Enskog, Anders ; Mölne, Johan ; Kvarnström, Niclas ; Diaz-Garcia, Cesar ; Hanafy, Ash ; Lundmark, Cecilia ; Marcickiewicz, Janusz ; Gäbel, Markus ; Groth, Klaus ; Akouri, Randa ; Eklind, Saskia ; Holgersson, Jan ; Tzakis, Andreas ; Olausson, Michael. / First clinical uterus transplantation trial : A six-month report. In: Fertility and Sterility. 2014 ; Vol. 101, No. 5. pp. 1228-1236.
@article{b006c9b420354f15bf1e5d3df6a795c5,
title = "First clinical uterus transplantation trial: A six-month report",
abstract = "OBJECTIVE: To report the 6-month results of the first clinical uterus transplantation (UTx) trial. This type of transplantation may become a treatment of absolute uterine-factor infertility (AUFI).DESIGN: Prospective observational study.SETTING: University hospital.PATIENT(S): Nine AUFI women and their live uterine donors, the majority being mothers.INTERVENTION(S): Live-donor UTx and low-dose induction immunosuppression.MAIN OUTCOME MEASURE(S): Data from preoperative investigations, surgery and follow-up for 6 months.RESULT(S): Durations of donor and recipient surgery ranged from 10 to 13 hours and from 4 to 6 hours, respectively. No immediate perioperative complications occurred in any of the recipients. After 6 months, seven uteri remained viable with regular menses. Mild rejection episodes occurred in four of these patients. These rejection episodes were effectively reversed by corticosteroid boluses. The two graft losses were because of acute bilateral thrombotic uterine artery occlusions and persistent intrauterine infection.CONCLUSION(S): The results demonstrate the feasibility of live-donor UTx with a low-dose immunosuppressive protocol.CLINICAL TRIAL REGISTRATION NUMBER: NCT01844362.",
author = "Mats Br{\"a}nnstr{\"o}m and Liza Johannesson and Pernilla Dahm-K{\"a}hler and Anders Enskog and Johan M{\"o}lne and Niclas Kvarnstr{\"o}m and Cesar Diaz-Garcia and Ash Hanafy and Cecilia Lundmark and Janusz Marcickiewicz and Markus G{\"a}bel and Klaus Groth and Randa Akouri and Saskia Eklind and Jan Holgersson and Andreas Tzakis and Michael Olausson",
note = "Copyright {\circledC} 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.",
year = "2014",
month = "5",
doi = "10.1016/j.fertnstert.2014.02.024",
language = "English",
volume = "101",
pages = "1228--1236",
journal = "Fertility and Sterility",
issn = "0015-0282",
publisher = "Elsevier",
number = "5",

}

Brännström, M, Johannesson, L, Dahm-Kähler, P, Enskog, A, Mölne, J, Kvarnström, N, Diaz-Garcia, C, Hanafy, A, Lundmark, C, Marcickiewicz, J, Gäbel, M, Groth, K, Akouri, R, Eklind, S, Holgersson, J, Tzakis, A & Olausson, M 2014, 'First clinical uterus transplantation trial: A six-month report' Fertility and Sterility, vol. 101, no. 5, pp. 1228-1236. https://doi.org/10.1016/j.fertnstert.2014.02.024

First clinical uterus transplantation trial : A six-month report. / Brännström, Mats; Johannesson, Liza; Dahm-Kähler, Pernilla; Enskog, Anders; Mölne, Johan; Kvarnström, Niclas; Diaz-Garcia, Cesar; Hanafy, Ash; Lundmark, Cecilia; Marcickiewicz, Janusz; Gäbel, Markus; Groth, Klaus; Akouri, Randa; Eklind, Saskia; Holgersson, Jan; Tzakis, Andreas; Olausson, Michael.

In: Fertility and Sterility, Vol. 101, No. 5, 05.2014, p. 1228-1236.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - First clinical uterus transplantation trial

T2 - A six-month report

AU - Brännström, Mats

AU - Johannesson, Liza

AU - Dahm-Kähler, Pernilla

AU - Enskog, Anders

AU - Mölne, Johan

AU - Kvarnström, Niclas

AU - Diaz-Garcia, Cesar

AU - Hanafy, Ash

AU - Lundmark, Cecilia

AU - Marcickiewicz, Janusz

AU - Gäbel, Markus

AU - Groth, Klaus

AU - Akouri, Randa

AU - Eklind, Saskia

AU - Holgersson, Jan

AU - Tzakis, Andreas

AU - Olausson, Michael

N1 - Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

PY - 2014/5

Y1 - 2014/5

N2 - OBJECTIVE: To report the 6-month results of the first clinical uterus transplantation (UTx) trial. This type of transplantation may become a treatment of absolute uterine-factor infertility (AUFI).DESIGN: Prospective observational study.SETTING: University hospital.PATIENT(S): Nine AUFI women and their live uterine donors, the majority being mothers.INTERVENTION(S): Live-donor UTx and low-dose induction immunosuppression.MAIN OUTCOME MEASURE(S): Data from preoperative investigations, surgery and follow-up for 6 months.RESULT(S): Durations of donor and recipient surgery ranged from 10 to 13 hours and from 4 to 6 hours, respectively. No immediate perioperative complications occurred in any of the recipients. After 6 months, seven uteri remained viable with regular menses. Mild rejection episodes occurred in four of these patients. These rejection episodes were effectively reversed by corticosteroid boluses. The two graft losses were because of acute bilateral thrombotic uterine artery occlusions and persistent intrauterine infection.CONCLUSION(S): The results demonstrate the feasibility of live-donor UTx with a low-dose immunosuppressive protocol.CLINICAL TRIAL REGISTRATION NUMBER: NCT01844362.

AB - OBJECTIVE: To report the 6-month results of the first clinical uterus transplantation (UTx) trial. This type of transplantation may become a treatment of absolute uterine-factor infertility (AUFI).DESIGN: Prospective observational study.SETTING: University hospital.PATIENT(S): Nine AUFI women and their live uterine donors, the majority being mothers.INTERVENTION(S): Live-donor UTx and low-dose induction immunosuppression.MAIN OUTCOME MEASURE(S): Data from preoperative investigations, surgery and follow-up for 6 months.RESULT(S): Durations of donor and recipient surgery ranged from 10 to 13 hours and from 4 to 6 hours, respectively. No immediate perioperative complications occurred in any of the recipients. After 6 months, seven uteri remained viable with regular menses. Mild rejection episodes occurred in four of these patients. These rejection episodes were effectively reversed by corticosteroid boluses. The two graft losses were because of acute bilateral thrombotic uterine artery occlusions and persistent intrauterine infection.CONCLUSION(S): The results demonstrate the feasibility of live-donor UTx with a low-dose immunosuppressive protocol.CLINICAL TRIAL REGISTRATION NUMBER: NCT01844362.

U2 - 10.1016/j.fertnstert.2014.02.024

DO - 10.1016/j.fertnstert.2014.02.024

M3 - Article

VL - 101

SP - 1228

EP - 1236

JO - Fertility and Sterility

JF - Fertility and Sterility

SN - 0015-0282

IS - 5

ER -

Brännström M, Johannesson L, Dahm-Kähler P, Enskog A, Mölne J, Kvarnström N et al. First clinical uterus transplantation trial: A six-month report. Fertility and Sterility. 2014 May;101(5):1228-1236. https://doi.org/10.1016/j.fertnstert.2014.02.024