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Living Donor Uterus Transplantation: A Single Center's Observations and Lessons Learned From Early Setbacks to Technical Success.

Journal article
Authors G Testa
E C Koon
L Johannesson
G J McKenna
T Anthony
G B Klintmalm
R T Gunby
A M Warren
J M Putman
G dePrisco
J M Mitchell
K Wallis
Michael Olausson
Published in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Volume 17
Issue 11
Pages 2901-2910
ISSN 1600-6143
Publication year 2017
Published at Institute of Clinical Sciences, Section for Surgery and Gastrosurgical Research and Education, Department of Plastic Surgery
Pages 2901-2910
Language en
Links dx.doi.org/10.1111/ajt.14326
Subject categories Transplantation surgery


Uterus transplantation is a vascularized composite allograft transplantation. It allows women who do not have a uterus to become pregnant and deliver a baby. In this paper, we analyze the first five cases of living donor uterus transplantation performed in the United States. The first three recipients lost their uterus grafts at days 14, 12, and 6, respectively, after transplant. Vascular complications, related to both inflow and outflow problems, were identified as the primary reason for the graft losses. Two recipients, at 6 and 3 mo, respectively, after transplant, have functioning grafts with regular menstrual cycles. Ultimate success will be claimed only after a live birth. This paper is an in-depth analysis of evaluation, surgical technique, and follow-up of these five living donor uterus transplants. The lessons learned were instrumental in allowing us to evolve from failure to technical and functional success. We aim to share our conclusions and build on knowledge in the evolving field of uterus transplantation.

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