Human Reproduction Update Advance Access published online on November 7, 2009
Human Reproduction Update, doi:10.1093/humupd/dmp049
Experimental uterus transplantation
1 Department of Obstetrics & Gynecology, Sahlgrenska University Hospital, Sahlgrenska Academy, University of Gothenburg, S-413 45 Göteborg, Sweden 2 Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine and Lenox Hill Hospital, New York, NY, USA
To whom correspondence should be addressed at: 3 Correspondence address. Fax: +46-31-418717; E-mail: mats.brannstrom{at}obgyn.gu.se
BACKGROUND: Uterus transplantation (UTx) is developed in animal models as a future method to treat uterine factor infertility.
METHODS: All published studies in the area of UTx research were identified. Aspects relating to surgery, cold-ischemia/reperfusion, rejection, immunosuppression, pregnancy, ethics and institutional requirements were examined.
RESULTS: Uterus retrieval surgery has been solved in animals, including primates. Studies on cold-ischemia/reperfusion indicate an ischemic tolerance of >24 h. The transplantation procedure, with vascular anastomosis, has not been fully developed in animal models, indicated by frequent thrombosis formation. Pregnancies have only been reported in syngenic/auto-UTx animal models. Several ethical issues in relation to UTx, and requirements for a team that would be suitable to undertake human UTx, exist.
CONCLUSION: Much research on UTx has been performed in appropriate animal models. Several aspects of the procedure have been optimized but some remain to be solved. It is predicted that the research will soon reach a stage that could merit introduction of human UTx as an experimental procedure.
Key words: infertility / pregnancy / transplantation / uterus
Received on January 30, 2009; revised October 1, 2009; accepted on October 7, 2009