Uterus transplantation: state of the art in 2021

Purpose To provide a comprehensive review of uterus transplantation in 2021, including a discussion of pregnancy outcomes of all reported births to date, the donor and recipient selection process, the organ procurement and transplant surgeries, reported complications, postoperative monitoring, preim...

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Bibliographic Details
Published in:Journal of assisted reproduction and genetics 2021-09, Vol.38 (9), p.2251-2259
Main Authors: Richards, Elliott G., Farrell, Ruth M., Ricci, Stephanie, Perni, Uma, Quintini, Cristiano, Tzakis, Andreas, Falcone, Tommaso
Format: Article
Language:English
Subjects:
Donors
Female
Graft rejection
Grafts
Gynecology
Health care
Human Genetics
Humans
Implantation
Infertility
Infertility, Female - therapy
Literature reviews
Live Birth
Medicine
Medicine & Public Health
Patients
Pregnancy
Pregnancy Outcome
Reproductive health
Reproductive Medicine
Reproductive Techniques, Assisted
Review
Thrombosis
Transplantation
Transplants & implants
Uterus
Uterus - transplantation
Vagina
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Summary:Purpose To provide a comprehensive review of uterus transplantation in 2021, including a discussion of pregnancy outcomes of all reported births to date, the donor and recipient selection process, the organ procurement and transplant surgeries, reported complications, postoperative monitoring, preimplantation preparation, and ethical considerations. Methods Literature review and expert commentary. Results Reports of thirty-one live births following uterus transplantation have been published from both living and deceased donors. The proper selection of donors and recipients is a labor-intensive process that requires advanced planning. A multidisciplinary team is critical. Reported complications in the recipient include thrombosis, infection, vaginal stricture, antenatal complications, and graft failure. Graft rejection is a common occurrence but rarely leads to graft removal. While most embryo transfers are successful, recurrent implantation failures in uterus transplant patients have been reported. Rates of preterm delivery are high but appear to be declining; more data, including long-term outcome data, is needed. Conclusions Uterus transplantation is an emerging therapy for absolute uterine factor infertility, a condition previously without direct treatment options. It is paramount that reproductive health care providers are familiar with the uterus transplantation process as more patients seek and receive this treatment.
ISSN:1058-0468
1573-7330
DOI:10.1007/s10815-021-02245-7