Current status of uterus transplantation in primates and issues for clinical application

Abstract

Objective: To clarify the current status of uterus transplantation (UT) and the medical, ethical, and social problems surrounding UT.

Design: Systematic review.

Setting: Not applicable.

Patient(s): Mainly nonhuman primates and humans.

Intervention(s): Not applicable.

Main outcome measure(s): A systematic search of Pubmed with the terms "uterus/uterine transplantation" was performed for English-language articles to review the current status of UT and issues associated with its clinical application, with a focus on nonhuman primate and human studies on UT.

Result(s): The first UT procedure in humans was conducted for a patient with absolute uterine infertility in Saudi Arabia in 2000. The transplanted uterus was removed after 99 days owing to prolapse and necrosis. That attempt led to a greater focus on basic UT experiments in animal models, including nonhuman primates. The subsequent accumulation of basic data has led to performance of UT in humans by groups in Turkey and Sweden. However, there has yet to be a pregnancy or delivery after allo-UT in primates. Moreover, there are many medical, ethical, and social problems that require examination before clinical application.

Conclusion(s): Clinical application of UT has just begun, but more basic data are needed and medical, ethical, and social problems require thorough discussion before clinical application.