Wednesday, 20 March, 2019

'Medical milestone' as first baby born from womb of dead donor

A medical team in São Paulo with a baby born via a uterine transplant.									Divulgação A medical team in São Paulo with a baby born via a uterine transplant. Divulgação
Ben Pena | 07 December, 2018, 08:13

The world's first baby born to a woman who had a uterus transplant from a deceased donor shows that such transplants can be successful, Brazilian doctors say.

It was then transplanted to the woman who was given medication to weaken her immune system so her body would not reject the uterus. The donor was a 45-year-old who died after a stroke that caused bleeding on the surface of the brain.

The baby was delivered via a caesarean section and weighed 2,550 grams at birth.

According to researchers, neither the mother nor the child have experienced complications or abnormalities. There have been previous attempts to birth a child using a transplanted uterus from a deceased donor, however, all have proved unsuccessful.

The researchers in Brazil reported that the uterus was ischemic - meaning, off a blood supply - for nearly eight hours, essentially double the reported time from any of the living donor transplants.

The authors say their version of the procedure isn't meant to replace the possibility of using a living donor, but rather to give women with uterine problems another option. Two babies have been born at Baylor University Medical Center in Texas and one in Serbia, also from transplants from living donors.

The current need for live donors "is a major limitation as donors are rare, typically being willing and eligible family members or close friends", Dr Ejzenberg said.

Research leader Dr Dani Ejzenberg, of Universidade de Sao Paulo in Brazil, said: "The use of deceased donors could greatly broaden access to this treatment and our results provide proof-of-concept for a new option for women with uterine infertility".

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The woman's pregnancy was normal, and doctors performed a Caesarean section on December 15, 2017, after about 36 weeks (a full term is about 40 weeks).

"Uterine transplant is a novel technique and should be regarded as experimental", he said.

While babies born from live donor uterus transplants have been done almost a dozen times before, including once in 2017 at Baylor Scott & White Hospital in Dallas, this birth marks the first time doctors have been able to remove the uterus from a recently deceased donor and have it result in a live birth. A woman who received a donated uterus from a deceased woman has given birth to a baby.

With this recent success comes not just the promise of greater access to donor organs, but vital information on what a transplanted uterus requires to successfully carry an embryo to full term.

The first childbirth following a uterus transplant occurred in 2013 in Sweden, where a total of eight children have been born thanks to transplants from live donors.

"She couldn't keep the uterus in another pregnancy", said Dr. Wellington Andraus, who worked on her transplant team.

Doctors said the breakthrough operation was the first successful case of its kind. Upon encountering a suitable candidate and donor, doctors must act quickly to remove the uterus and transport it to the patient.

Researchers not involved in the study cautioned that, given all the biological constraints, the pool of potential uterus donors is actually quite small, even taking into account deceased donors. Within this group about one in 500 women have irreversible infertility - which can be due to a congenital malformation, cancer, or other illness, leading to genetic absence or removal of the uterus.

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