Uterus transplantation, current prospect and future indications. State of art with review of literature

• Published in: Gynécologie, obstétrique, fertilité & sénologie obstétrique, fertilité & sénologie, 2021-03, Vol.49 (3), p.193-203
• Main Authors: Dion, L, Jacquot Thierry, L, Tardieu, A, Carbonnel, M, Ayoubi, J-M, Gauthier, T, Lavoué, V
• Format: Article
• Language: fre
• ISSN: 2468-7189
• DOI: 10.1016/j.gofs.2020.09.001

The aim of this review is to summarize the development of UT on worldwide and to develop the new questions posed by this technique in 2020. According to the PRISMA model, via Pubmed, we searched for publications containing the keywords: uterus transplantation; UT and cryopreservation from 2000 to 2020. At least 76 UTx have been carried out around the world and 19 healthy babies were born. The main indication remains the uterine agenesis (MRKH Syndrome>85% cases) then the history of hysterectomy (hemorrhage of the delivery or cervical cancer) and the non-functional uterus (Asherman's syndrome, diffuse adenomyosis). The 2 types of donors (living and deceased) are developed representing respectively 75% and 25% of the TU; the success rate in terms of return of rules is better in the living donor group and is 79% vs 68% in the deceased donor group. The choice of donor type must take into account the constraints of both procedures. Surgical complications (grade III) for the donor are estimated to be 14% mainly represented by ureter wounds. Technical simplifications concerning the venous return of the graft but also the carrying out of robot-assisted surgery would reduce the operating time for the donor and facilitate the collection process. TU is a complementary alternative to GPA and adoption allowing patients to be surrogates, legal and biological of the baby. An extension of the indications to patients with non absolute uterine infertility is in the process of democratization.