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Uterine Tissue Engineering and the Future of Uterus Transplantation.

Journal article
Authors Mats Hellström
Sara Bandstein
Mats Brännström
Published in Annals of biomedical engineering
Volume 45
Issue 7
Pages 1718–1730
ISSN 1573-9686
Publication year 2017
Published at Institute of Clinical Sciences, Section for the Health of Women and Children, Department of Obstetrics and Gynecology
Pages 1718–1730
Language en
Links dx.doi.org/10.1007/s10439-016-1776-...
Subject categories Obstetrics, Gynecology and Reproductive Medicine


The recent successful births following live donor uterus transplantation are proof-of-concept that absolute uterine factor infertility is a treatable condition which affects several hundred thousand infertile women world-wide due to a dysfunctional uterus. This strategy also provides an alternative to gestational surrogate motherhood which is not practiced in most countries due to ethical, religious or legal reasons. The live donor surgery involved in uterus transplantation takes more than 10 h and is then followed by years of immunosuppressive medication to prevent uterine rejection. Immunosuppression is associated with significant adverse side effects, including nephrotoxicity, increased risk of serious infections, and diabetes. Thus, the development of alternative approaches to treat absolute uterine factor infertility would be desirable. This review discusses tissue engineering principles in general, but also details strategies on how to create a bioengineered uterus that could be used for transplantation, without risky donor surgery and any need for immunosuppression. We discuss scaffolds derived from decellularized organs/tissues which may be recellularized using various types of autologous somatic/stem cells, in particular for uterine tissue engineering. It further highlights the hurdles that lay ahead in developing an alternative to an allogeneic source for uterus transplantation.

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