Spain performs its first uterus transplant from a living donor

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The Clinic of Barcelona has carried out the transplant of this organ between two sisters

The Hospital Clínic de Barcelona has carried out the first uterus transplant in Spain from a living donor, who has donated it to her sister, who was born without this organ, which is known as Rokitansky syndrome, this center reported this Thursday doctor in a statement.

The transplant was carried out on October 5, led by the heads of the Gynecology services of the Hospital Clinic, Francesc Carmona, and of Urology and Renal Transplantation, Antonio Alcaraz.

The process that has led to this pioneering intervention began five years ago and is part of the research project “Feasibility study of a living donor uterine transplant procedure with obtaining a graft for robotic surgery”, to validate the viability of this surgery.

The main requirement to be a candidate for this type of operation is to suffer from Rokitansky syndrome, which is a congenital disorder of the female reproductive system that affects one in every 5,000 women in the world.

These women are born without a uterus and fallopian tubes and, in the specific case of the transplant recipient, she was the only compatible candidate out of 30 who presented for a transplant.

The Clinic has reported today that uterus transplantation is a highly complex process that is divided into two phases: the removal of the organ carried out by robotic surgery, to be as less invasive as possible, and its implantation, which required open surgery.

The duration of the operation was about twelve hours, in terms of extraction, and another four for implantation.
A multidisciplinary team of more than 20 people performed the transplant, including gynecologists, transplant surgeons, gynecology and transplant nurses, anesthetists, and nursing assistants.

Dr. Antonio Alcaraz explained that the uterus “is a complex organ, with poor vascularization of the arteries and a large network of veins, of which the largest must be sought to drain the blood that reaches the uterus.”

Added to these difficulties is the subsequent process that focuses on the recipient since, according to Dr. Carmona, the success of everything “is determined by the viability of the organ, that it functions and that the woman becomes pregnant.”

The health evolution of the woman receiving her sister’s uterus, two months after the operation, is good and she has already had her first menstrual cycle, the same sources have reported.

At this point in the process, the woman is expected to be implanted with an embryo of the eleven previously fertilized in vitro, so that she can become pregnant.

In the event that she becomes pregnant, immunosuppressive drugs will be maintained – to prevent her immune system from damaging the transplanted organ – until a second pregnancy.

Once her wish to be a mother is complete, the donated uterus will be removed by laparoscopy after the second delivery, provided that this is her gestational wish.

This has been the first uterus transplant performed in Spain, but not in Europe, since the first birth after another transplant from a living donor took place in Sweden in 2014, specifically at the University Hospital of Sahlgrenska, of the University from Gothenburg, and was led by Dr. Mats Brännström.

To date, 70 uterus transplants have been performed around the world, from which around twenty babies have been born.

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