Pediatrics
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From the Journals

Uterus Transplant: 70% Success Rate—With Notable Complications

In a small study, uterus allograft was successful in the majority of recipients; however, adverse events were common among both recipients and donors.

Conexiant

Of 20 women in a small study who underwent uterus transplantation, 14 achieved successful grafts, resulting in the birth of 16 healthy infants, according to a recent study.

Researchers assessed the feasibility and safety of uterus transplantation in women with absolute uterine-factor infertility, a condition characterized by the absence or dysfunction of the uterus, rendering natural pregnancy impossible. This case series, results of which were published in JAMA, included 20 participants aged 20 to 36 years (median age = 30 years) who underwent uterus transplantation at a U.S. tertiary care center between September 2016 and August 2019. Of the 20 participants, 16 identified as White, 2 as Asian, and 1 as Black. Among the living donors, the median age was 37 years, ranging from 30 to 56 years, with a median of two previous live births (range = 1–7).

Out of the 20 uterus transplants performed, 14 were successful, representing a 70% success rate. These successful transplants resulted in the birth of 16 infants. The median time to the first live birth following the transplant was 14.2 months, with a range of 11 to 53.9 months. Six out of the 20 transplants failed, representing a 30% failure rate, with all failures occurring within the first 2 weeks post-transplant.

Complications occurred in 11 out of 20 recipients (55%). Among the successful pregnancies, there were two cases (14%) of gestational hypertension, two cases (14%) of cervical insufficiency, and two cases (14%) of preterm labor. Additionally, four living donors experienced grade 3 complications, reflecting the surgical risks involved for both donors and recipients.

No congenital malformations or developmental delays were observed in the 16 live-born children, although long-term follow-up is necessary.

The study authors concluded, "Uterus transplant was technically feasible and was associated with a high live birth rate following successful graft survival. Adverse events were common, with medical and surgical risks affecting recipients as well as donors."

Full disclosures can be found in the published study.