Transplanted uterus without pregnancy?

Transplanted uterus: is a pregnancy possible?

15/01/2014

Transplants and life-saving transplants have been successfully performed for a long time. It was used by doctors mainly liver, kidneys and also hearts successfully in the bodies of other people. It is only recently that hands, faces and other parts of the body are increasingly being added so that patients can enjoy a better quality of life again.

Some time ago there was a transplant scandal in Germany, in which, for example, a doctor from Göttingen had advised his patients to transplant, although there was no medical need. He manipulated the logs for that. Such messages are unsettling and contribute to the fact that the readiness for organ donation continues to decline.

But this incident is the exception. Currently it has been reported that Swedish physicians have used nine women from a womb of the immediate female relatives. This has been the first intervention of this kind in Europe. Certainly, this message is to be considered as another milestone in medicine, but at the Gothenburg University Hospital remains the question of whether the women are also able to give birth to children.

"This is a new kind of surgery," says Brannstrom, who heads the obstetrics and gynecology department at the clinic. Due to the novelty, there is no such intervention yet „textbook“ explains the doctor. Therefore, in February he and his colleagues would like to offer a seminar, which should also take place on the basis of a scientific report.

Successful transplant in Turkey and Saudi Arabia
In the past, transplantation of uteri has already been successfully carried out in Turkey and Saudi Arabia. None of the women could then get pregnant, as hoped. The nine patients in the Swedish clinic were either born without a uterus or had to have them removed because of tumors. In order to enable them to become pregnant, they were temporarily transplanted the organs. If there are no complications, the doctors want to use the embryos, as it seems „The world“ can be seen.

In addition to ethical issues, physical problems, especially in the early days after a transplant, are not uncommon. For example, a kidney transplant often weakens the immune system and increases the risk of certain infections. The trigger for this are the drugs needed to prevent rejection of the foreign organ. As a result of the medication, the transplants in Sweden may also develop high blood pressure, swelling, diabetes and an increased risk of cancer, so that the organs should be removed again after two pregnancies at the latest.

Fertilization only artificially possible
For some of the patients, the period was six weeks after transplantation, which is a sign of healthy functioning organs for the doctors and none of the recipient had to receive intensive care after the operation. Artificial insemination is necessary because the uterus was not connected to the fallopian tubes during the operation. This prevents pregnancy by natural means.

The Swedish project is being pursued by physicians worldwide, because the intervention is highly risky for the donors. British authorities said the risk was too great, says the physician Richard Smith of the organization Womb Transplant UK. They prefer to resort to uteri of dying or dead.

Supply from the placenta is not clear
In addition to the possible life-threatening consequences for the participants, the question of adequate care of the babies through the placenta, a further concern of the physicians dar. "It is a research study," says the physician. "Women may be able to have children, but there are no guarantees," says Brannstrom. The uterus transplants successfully practiced in mice, sheep and baboons provide hope. The primates could not get any offspring. (Fr)