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Living-Donor Uterus Transplantation: A Clinical Review

Title: Living-Donor Uterus Transplantation: A Clinical Review
Authors: Massimiliano Veroux; Paolo Scollo; Martina Maria Giambra; Giuseppe Roscitano; Alessia Giaquinta; Francesco Setacci; Pierfrancesco Veroux
Source: Journal of Clinical Medicine, Vol 13, Iss 3, p 775 (2024)
Publisher Information: MDPI AG
Publication Year: 2024
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: Mayer–Rokitansky–Küster–Hauser syndrome; hysterectomy; robotic; laparoscopic; live births; deceased donor; Medicine
Description: Uterus transplantation (UTx) is currently the only available treatment for absolute uterine factor infertility. More than 90 uterus transplantations have been performed worldwide, mostly from living donors. Living-donor (LD) UTx is a challenging surgical procedure since it poses ethical issues, and it is a high-risk and invasive surgery with higher hysterectomy-related risks compared to conventional hysterectomy. A total of 59 living-donor hysterectomies have been reported in the literature, including 35 performed with a laparotomic approach, 20 with a robotic approach and 4 with a laparoscopic approach. The mean donor age was 45.6 ± 9.1 years, and 22 were unrelated with the recipients, 34 were emotionally related (27 mothers, 5 sisters, 2 mother’s sisters). The mean recipient age was 28.8 ± 4.5 years. Mayer–Rokitansky–Küster–Hauser syndrome was the most common indication for uterus transplant. Robotic living-donor hysterectomy had the longest operative time but resulted in a lower blood loss and postoperative stay compared to laparotomic and laparoscopic approaches. Twenty-nine births from LD-UTx have been reported, four after robotic living-donor hysterectomy and twenty-five after a laparotomic procedure. UTx is now an effective treatment for women with UFI. While living-donor UTx in some cases may be considered an experimental procedure, it offers the extraordinary possibility to give women the opportunity to have a pregnancy. Many efforts should be made to reduce the potential risks for donors, including the use of mini-invasive techniques, and the efficacy of UTx in the recipients, giving the potential harm of immunosuppression in a recipient of a non-life-saving organ.
Document Type: article in journal/newspaper
Language: English
ISBN: 978-7-272-88187-2; 7-272-88187-9
Relation: https://www.mdpi.com/2077-0383/13/3/775; https://doaj.org/toc/2077-0383; https://doaj.org/article/7272881879504153aef419adeb698489
DOI: 10.3390/jcm13030775
Availability: https://doi.org/10.3390/jcm13030775; https://doaj.org/article/7272881879504153aef419adeb698489
Accession Number: edsbas.67EB0984
Database: BASE