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Living-Donor Uterus Transplantation: Pre-, Intra-, and Postoperative Parameters Relevant to Surgical Success, Pregnancy, and Obstetrics with Live Births

Uterus transplantation (UTx) can provide a route to motherhood for women with Mayer–Rokitansky–Küster–Hauser syndrome (MRKHS), a congenital disorder characterized by uterovaginal aplasia, but with functional ovaries. Based on our four successful living-donor transplantations and two resulting births...

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Autores principales: Brucker, Sara Yvonne, Strowitzki, Thomas, Taran, Florin-Andrei, Rall, Katharina, Schöller, Dorit, Hoopmann, Markus, Henes, Melanie, Guthoff, Martina, Heyne, Nils, Zipfel, Stephan, Schäffeler, Norbert, Bösmüller, Hans, Fend, Falko, Rosenberger, Peter, Heim, Eckhard, Wiesing, Urban, Nikolaou, Konstantin, Fleischer, Sabrina, Bakchoul, Tamam, Poets, Christian F., Goelz, Rangmar, Wiechers, Cornelia, Kagan, Karl-Oliver, Krämer, Bernhard, Reisenauer, Christl, Oberlechner, Ernst, Hübner, Stephanie, Abele, Harald, Dahm-Kähler, Pernilla, Kvarnström, Niclas, Brännström, Mats, Nadalin, Silvio, Wallwiener, Diethelm, Königsrainer, Alfred
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464820/
https://www.ncbi.nlm.nih.gov/pubmed/32756295
http://dx.doi.org/10.3390/jcm9082485
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author Brucker, Sara Yvonne
Strowitzki, Thomas
Taran, Florin-Andrei
Rall, Katharina
Schöller, Dorit
Hoopmann, Markus
Henes, Melanie
Guthoff, Martina
Heyne, Nils
Zipfel, Stephan
Schäffeler, Norbert
Bösmüller, Hans
Fend, Falko
Rosenberger, Peter
Heim, Eckhard
Wiesing, Urban
Nikolaou, Konstantin
Fleischer, Sabrina
Bakchoul, Tamam
Poets, Christian F.
Goelz, Rangmar
Wiechers, Cornelia
Kagan, Karl-Oliver
Krämer, Bernhard
Reisenauer, Christl
Oberlechner, Ernst
Hübner, Stephanie
Abele, Harald
Dahm-Kähler, Pernilla
Kvarnström, Niclas
Brännström, Mats
Nadalin, Silvio
Wallwiener, Diethelm
Königsrainer, Alfred
author_facet Brucker, Sara Yvonne
Strowitzki, Thomas
Taran, Florin-Andrei
Rall, Katharina
Schöller, Dorit
Hoopmann, Markus
Henes, Melanie
Guthoff, Martina
Heyne, Nils
Zipfel, Stephan
Schäffeler, Norbert
Bösmüller, Hans
Fend, Falko
Rosenberger, Peter
Heim, Eckhard
Wiesing, Urban
Nikolaou, Konstantin
Fleischer, Sabrina
Bakchoul, Tamam
Poets, Christian F.
Goelz, Rangmar
Wiechers, Cornelia
Kagan, Karl-Oliver
Krämer, Bernhard
Reisenauer, Christl
Oberlechner, Ernst
Hübner, Stephanie
Abele, Harald
Dahm-Kähler, Pernilla
Kvarnström, Niclas
Brännström, Mats
Nadalin, Silvio
Wallwiener, Diethelm
Königsrainer, Alfred
author_sort Brucker, Sara Yvonne
collection PubMed
description Uterus transplantation (UTx) can provide a route to motherhood for women with Mayer–Rokitansky–Küster–Hauser syndrome (MRKHS), a congenital disorder characterized by uterovaginal aplasia, but with functional ovaries. Based on our four successful living-donor transplantations and two resulting births, this analysis presents parameters relevant to standardizing recipient/donor selection, UTx surgery, and postoperative treatment, and their implementation in routine settings. We descriptively analyzed prospectively collected observational data from our four uterus recipients, all with MRKHS, their living donors, and the two newborns born to two recipients, including 1-year postnatal follow-ups. Analysis included only living-donor/recipient pairs with completed donor/recipient surgery. Two recipients, both requiring ovarian restimulation under immunosuppression after missed pregnancy loss in one case and no pregnancy in the other, each delivered a healthy boy by cesarean section. We conclude that parameters crucial to successful transplantation, pregnancy, and childbirth include careful selection of donor/recipient pairs, donor organ quality, meticulous surgical technique, a multidisciplinary team approach, and comprehensive follow-up. Surgery duration and blood vessel selection await further optimization, as do the choice and duration of immunosuppression, which are crucial to timing the first embryo transfer. Data need to be collected in an international registry due to the low prevalence of MRKHS.
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spelling pubmed-74648202020-09-04 Living-Donor Uterus Transplantation: Pre-, Intra-, and Postoperative Parameters Relevant to Surgical Success, Pregnancy, and Obstetrics with Live Births Brucker, Sara Yvonne Strowitzki, Thomas Taran, Florin-Andrei Rall, Katharina Schöller, Dorit Hoopmann, Markus Henes, Melanie Guthoff, Martina Heyne, Nils Zipfel, Stephan Schäffeler, Norbert Bösmüller, Hans Fend, Falko Rosenberger, Peter Heim, Eckhard Wiesing, Urban Nikolaou, Konstantin Fleischer, Sabrina Bakchoul, Tamam Poets, Christian F. Goelz, Rangmar Wiechers, Cornelia Kagan, Karl-Oliver Krämer, Bernhard Reisenauer, Christl Oberlechner, Ernst Hübner, Stephanie Abele, Harald Dahm-Kähler, Pernilla Kvarnström, Niclas Brännström, Mats Nadalin, Silvio Wallwiener, Diethelm Königsrainer, Alfred J Clin Med Article Uterus transplantation (UTx) can provide a route to motherhood for women with Mayer–Rokitansky–Küster–Hauser syndrome (MRKHS), a congenital disorder characterized by uterovaginal aplasia, but with functional ovaries. Based on our four successful living-donor transplantations and two resulting births, this analysis presents parameters relevant to standardizing recipient/donor selection, UTx surgery, and postoperative treatment, and their implementation in routine settings. We descriptively analyzed prospectively collected observational data from our four uterus recipients, all with MRKHS, their living donors, and the two newborns born to two recipients, including 1-year postnatal follow-ups. Analysis included only living-donor/recipient pairs with completed donor/recipient surgery. Two recipients, both requiring ovarian restimulation under immunosuppression after missed pregnancy loss in one case and no pregnancy in the other, each delivered a healthy boy by cesarean section. We conclude that parameters crucial to successful transplantation, pregnancy, and childbirth include careful selection of donor/recipient pairs, donor organ quality, meticulous surgical technique, a multidisciplinary team approach, and comprehensive follow-up. Surgery duration and blood vessel selection await further optimization, as do the choice and duration of immunosuppression, which are crucial to timing the first embryo transfer. Data need to be collected in an international registry due to the low prevalence of MRKHS. MDPI 2020-08-03 /pmc/articles/PMC7464820/ /pubmed/32756295 http://dx.doi.org/10.3390/jcm9082485 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Brucker, Sara Yvonne
Strowitzki, Thomas
Taran, Florin-Andrei
Rall, Katharina
Schöller, Dorit
Hoopmann, Markus
Henes, Melanie
Guthoff, Martina
Heyne, Nils
Zipfel, Stephan
Schäffeler, Norbert
Bösmüller, Hans
Fend, Falko
Rosenberger, Peter
Heim, Eckhard
Wiesing, Urban
Nikolaou, Konstantin
Fleischer, Sabrina
Bakchoul, Tamam
Poets, Christian F.
Goelz, Rangmar
Wiechers, Cornelia
Kagan, Karl-Oliver
Krämer, Bernhard
Reisenauer, Christl
Oberlechner, Ernst
Hübner, Stephanie
Abele, Harald
Dahm-Kähler, Pernilla
Kvarnström, Niclas
Brännström, Mats
Nadalin, Silvio
Wallwiener, Diethelm
Königsrainer, Alfred
Living-Donor Uterus Transplantation: Pre-, Intra-, and Postoperative Parameters Relevant to Surgical Success, Pregnancy, and Obstetrics with Live Births
title Living-Donor Uterus Transplantation: Pre-, Intra-, and Postoperative Parameters Relevant to Surgical Success, Pregnancy, and Obstetrics with Live Births
title_full Living-Donor Uterus Transplantation: Pre-, Intra-, and Postoperative Parameters Relevant to Surgical Success, Pregnancy, and Obstetrics with Live Births
title_fullStr Living-Donor Uterus Transplantation: Pre-, Intra-, and Postoperative Parameters Relevant to Surgical Success, Pregnancy, and Obstetrics with Live Births
title_full_unstemmed Living-Donor Uterus Transplantation: Pre-, Intra-, and Postoperative Parameters Relevant to Surgical Success, Pregnancy, and Obstetrics with Live Births
title_short Living-Donor Uterus Transplantation: Pre-, Intra-, and Postoperative Parameters Relevant to Surgical Success, Pregnancy, and Obstetrics with Live Births
title_sort living-donor uterus transplantation: pre-, intra-, and postoperative parameters relevant to surgical success, pregnancy, and obstetrics with live births
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464820/
https://www.ncbi.nlm.nih.gov/pubmed/32756295
http://dx.doi.org/10.3390/jcm9082485
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