The Cleveland Clinic announced yesterday that a team of its surgeons accomplished the first uterus transplant in the United States. Sweden was the first to accomplish this feat and announced the first of successful births following a transplant in 2014.
Uterus transplant a success?
The operation took around nine hours and beat out a team from the Baylor University Medical Center that is expected to undergo one of its own transplants in the coming weeks.
The recipient is 26-year old woman who, for now, has asked that she remains unnamed while she recovers from the surgery. The clinic said that she was in stable condition but declined to give any additional details. The surgery will provide hope to thousands of women either born without a uterus or have lost theirs to disease or injury. Many of these women have issues with the safer surrogate or adoption options “for reasons that are personal, cultural or religious,” according to the leader of the transplant team, Dr. Andreas G. Tzakis.
In a questionnaire during screening, the recipient explained why she wanted to be one of the ten women approved by the ethics board of the Cleveland Clinic to receive the transplant. Roughly 50,000 women in the United States could benefit from the procedure.
“I crave that experience,” she said. “I want the morning sickness, the backaches, the feet swelling. I want to feel the baby move. That is something I’ve wanted for as long as I can remember.”
Pregnancy remains a “down the road” event
Prior to the procedure the patient had her eggs surgically removed, fertilized with her husband’s sperm and frozen. After at least a year, the embryos will need to be implanted in the uterus. The year wait for an attempted pregnancy is meant to let the patient heal as well as allow the doctors to adjust the levels of medications she will be taking to prevent rejection of the new uterus. The uterus came from a deceased organ donor.
Dr. Andreas Tzakis has performed somewhere between 4,000 and 5,000 kidney, liver and other abdominal organ transplants in his illustrious career. In order to best tackle this particular groundbreaking transplant, Dr. Tzakis traveled to Sweden in order to work with doctors at the University of Gothenburg who are the only ones in the world to have accomplished this feat before yesterday’s transplant.
Unlike yesterday’s transplant those organs came from live donors in the nine transplants they’ve performed. The use of live donors doubles the risks in these procedures by definition and like yesterday’s transplant, beg an ethical argument.
Are these operations worth the risk? Especially as they are not meant to be permanent. One could argue that a face or hand transplant isn’t medically necessary but like the uterus transplant surely does improve life for the recipient.
One important difference: “Unlike any other transplants, they are ‘ephemeral,“’ Tzakis said last year in a statement announcing the study. “They are not intended to last for the duration of the recipient’s life, but will be maintained for only as long as is necessary to produce one or two children.”
The removal is done so that the patient can stop with the medications that reduce the risk of organ rejection.
The Cleveland Clinic’s ethics board agreed that the procedure is beneficial and approved ten initial transplants and the clinic is still screening women interested in the procedure. Following the results of the surgeries, the clinic’s ethics officials will decide if the clinic will offer the transplant as a standard procedure for women who qualify.