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. 2020 Sep 1;272(3):411-417.
doi: 10.1097/SLA.0000000000004199.

The Evolution of Transplantation From Saving Lives to Fertility Treatment: DUETS (Dallas UtErus Transplant Study)

Giuliano Testa  1 , Greg J McKenna  1 , Johanna Bayer  1 , Anji Wall  1 , Hoylan Fernandez  1 , Eric Martinez  1 , Amar Gupta  1 , Richard Ruiz  1 , Nicholas Onaca  1 , Robert T Gunby  2 , Anthony R Gregg  2 , Michael Olausson  3 , E Colin Koon  2 , Liza Johannesson  1   2
Affiliations

The Evolution of Transplantation From Saving Lives to Fertility Treatment: DUETS (Dallas UtErus Transplant Study)

Giuliano Testa et al. Ann Surg. .

Abstract

Objective: We report the results of the first 20 uterus transplants performed in our institution.

Summary background data: Uterus transplantation (UTx) aims at giving women affected by absolute uterine-factor infertility the possibility of carrying their own pregnancy. UTx has evolved from experimental to an established surgical procedure.

Methods: The Dallas Uterus Transplant Study (DUETS) program started in 2016. The uterus was transplanted in orthotopic position with vascular anastomoses to the external iliac vessels and removed when 1 or 2 live births were achieved. Immunosuppression lasted only for the duration of the uterus graft.

Results: Twenty women, median age 29.7 years, enrolled in the study, with 10 in phase 1 and 10 in phase 2. All but 2 recipients had a congenital absence of the uterus. Eighteen recipients received uteri from living donors and 2 from deceased donors. In phase 1, 50% of recipients had a technically successful uterus transplant, compared to 90% in phase 2. Four recipients with a technical success in phase 1 have delivered 1 or 2 babies, and the fifth recipient with a technical success is >30 weeks pregnant. In phase 2, 2 recipients have delivered healthy babies and 5 are pregnant.

Conclusions: UTx is a unique type of transplant; whose only true success is a healthy child birth. Based on results presented here, involving refinement of the surgical technique and donor selection process, UTx is now an established solution for absolute uterine-factor infertility.

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Conflict of interest statement

The authors report no conflicts of interest.

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References

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