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Uterus transplantation

Bethany Bruno, Kavita Shah Arora
No abstract text is available yet for this article.
September 2018: American Journal of Bioethics: AJOB
Jennifer L Wainright, Christopher L Wholley, John Rosendale, Wida S Cherikh, Darren Di Battista, David K Klassen
BACKGROUND: Vascularized composite allograft (VCA) transplants include diverse organ types and are made possible primarily by deceased donors. METHODS: We used Organ Procurement and Transplantation Network (OPTN) data to characterize VCA deceased donors (n=66 of 70) in the United States 1998-2017 and compare their characteristics with those of kidney donors in 2017. RESULTS: Through December 31, 2017, 20 transplant programs performed 72 deceased donor VCA transplants, with organs donated by 70 donors, including 30 upper limb (17 unilateral and 13 bilateral) and 11 face donors...
September 17, 2018: Transplantation
(no author information available yet)
Following the birth of the first child from a transplanted uterus in Gothenburg, Sweden, in 2014, other centers worldwide have produced scientific reports of successful uterus transplantation, as well as more recent media reports of successful births. The American Society for Reproductive Medicine recognizes uterus transplantation as the first successful medical treatment of absolute uterus factor infertility, while cautioning health professionals, patient advocacy groups, and the public about its highly experimental nature...
September 2018: Fertility and Sterility
Amel Alghrani
Whilst internationally a growing body of literature is emerging on uterus transplantation as the latest advance in assisted reproductive technology, much of this has been devoted to responding to the ethical questions raised by this procedure in the context of its immediate purpose, to restore fertility in cisgender women. Very few have addressed whether it can be claimed that there is a right to gestate under the umbrella of procreative liberty, nor whether such a right, if it does exist, applies not only to cisgender women, but also transgender and gender variant individuals and cisgender men...
August 2018: Journal of Law and the Biosciences
Valarie K Blake
The first baby has successfully been born by uterus transplantation (UTx) in the United States and the procedure is swiftly becoming a viable clinical option for patients with uterine factor infertility (UFI). This raises a practical ethical question: should health insurers finance UTx and what issues should they consider in coming to this decision? The article lays forth some of the factors that shape the decision over whether to finance UTx in the United States, including what procedures must be covered, whether UTx is more like organ transplantation or infertility treatment (which are treated differently in the United States), and the benefits and alternatives of the procedure...
August 31, 2018: Bioethics
Roman Chmel, Marta Novackova, Libor Janousek, Jan Matecha, Zlatko Pastor, Jana Maluskova, Milos Cekal, Jakub Kristek, Michael Olausson, Jiri Fronek
While uterus transplantation is still in the experimental stage, it has promising potential as a treatment for women with absolute uterine factor infertility based on the childbirths from living donor trials conducted in Sweden and the United States. We report the main characteristics and perioperative and postoperative courses of both recipients and donors following four deceased donor and five living donor uterus transplantations. Three main priorities differentiate this study from the previously reported uterus transplantations...
August 27, 2018: American Journal of Transplantation
Mats Brännström
PURPOSE OF REVIEW: The current review gives an updated synopsis of all cases of uterus transplantation (UTx) that has been published and technical details about surgery. The live births that so far have been reported are described regarding pregnancy and outcome. In addition, the review highlights some specific areas of live donor UTx, deceased donor UTx and UTx in general that need further research for clarification/optimization. It is predicted that the clinical field of UTx will expand rapidly and recommendations for a scientific development of the UTx field are presented...
October 2018: Current Opinion in Organ Transplantation
Branislav Kollar, Sotirios Tasigiorgos, Miguel I Dorante, Matthew J Carty, Simon G Talbot, Bohdan Pomahac
In the past 20 years, reconstructive transplantation (RT) has emerged as a viable reconstructive option for carefully selected patients. More than 100 upper extremity and 40 face transplants have been performed worldwide to date. Concomitantly, the portfolio of reconstructive transplantation has been extended by additional procedures such as lower extremities, abdominal wall, neck, uterus, genitourinary, and pediatric transplants. In the present review article, we aim to summarize the current state of knowledge about this exciting field...
August 11, 2018: Journal of Surgical Oncology
Wida S Cherikh, Linda C Cendales, Christopher L Wholley, Jennifer Wainright, Vijay S Gorantla, David K Klassen, Sue McDiarmid, L Scott Levin
On July 3, 2014, the Organ Procurement and Transplantation Network/United Network for Organ Sharing was charged with the oversight of Vascularized Composite Allograft (VCA) procurement and transplantation in the U.S. As of December 31, 2017, 61 VCA programs at 27 centers were approved in the U.S. Fifty candidates have been added to the waiting list at 15 centers. Twenty-eight VCA transplants have been performed at 14 programs (10 upper limb, 10 uterus, 5 craniofacial, 1 scalp, 1 abdominal wall, and 1 penile)...
August 9, 2018: American Journal of Transplantation
Stina Järvholm, Ann Marie Warren, Maria Jalmbrant, Niclas Kvarnström, Giuliano Testa, Liza Johannesson
Uterus transplant has become a real option for women with uterine-factor infertility to become pregnant and give birth. The screening before uterus transplant consists of a multidisciplinary evaluation and includes the potential recipient, living donor, and, to some extent, the recipient's partner and future co-parent. The psychological evaluation has evolved from broad-based screening in the first uterus transplant trial, where the aim was to find suitable candidates for a novel experimental procedure with an unknown outcome, to a more directed screening with specific psychological domains for a complex infertility treatment with promising results...
July 30, 2018: American Journal of Transplantation
Lisa Guntram, Nicola Jane Williams
Within the ethics and science literature surrounding uterus transplantation (UTx), emphasis is often placed on the extent to which UTx might improve upon, or offer additional benefits when compared to, existing 'treatment options' for women with absolute uterine factor infertility, such as adoption and gestational surrogacy. Within this literature UTx is often positioned as superior to surrogacy because it can deliver things that surrogacy cannot (such as the experience of gestation). Yet, in addition to claims that UTx is superior in the aforementioned sense it is also often assumed (either implicitly or explicitly) that UTx is less fraught with ethical difficulties and thus should be considered a less morally problematic option...
July 26, 2018: Bioethics
Nicola Jane Williams
No abstract text is available yet for this article.
July 2018: American Journal of Bioethics: AJOB
Alix Rogers
No abstract text is available yet for this article.
July 2018: American Journal of Bioethics: AJOB
Anji Wall, Giuliano Testa
No abstract text is available yet for this article.
July 2018: American Journal of Bioethics: AJOB
Michael E Shapiro, Frances Rieth Ward
No abstract text is available yet for this article.
July 2018: American Journal of Bioethics: AJOB
Gerard Vong
No abstract text is available yet for this article.
July 2018: American Journal of Bioethics: AJOB
Bethany Bruno, Kavita Shah Arora
Research teams have made considerable progress in treating absolute uterine factor infertility through uterus transplantation, though studies have differed on the choice of either deceased or living donors. While researchers continue to analyze the medical feasibility of both approaches, little attention has been paid to the ethics of using deceased versus living donors as well as the protections that must be in place for each. Both types of uterus donation also pose unique regulatory challenges, including how to allocate donated organs; whether the donor / donor's family has any rights to the uterus and resulting child; how to manage contact between the donor / donor's family, recipient, and resulting child; and how to track outcomes moving forward...
July 2018: American Journal of Bioethics: AJOB
Ana Esteve-Solé, Yiyi Luo, Alexandru Vlagea, Ángela Deyà-Martínez, Jordi Yagüe, Ana María Plaza-Martín, Manel Juan, Laia Alsina
Pregnancy and early infancy represent two very particular immunological states. During pregnancy, the haploidentical fetus and the pregnant women develop tolerance mechanisms to avoid rejection; then, just after birth, the neonatal immune system must modulate the transition from the virtually sterile but haploidentical uterus to a world full of antigens and the rapid microbial colonization of the mucosa. B regulatory (Breg) cells are a recently discovered B cell subset thought to play a pivotal role in different conditions such as chronic infections, autoimmunity, cancer, and transplantation among others in addition to pregnancy...
July 19, 2018: International Journal of Molecular Sciences
Mianna Lotz
This paper urges reconsideration of analyses of the alternatives to reproductive uterus transplantation (UTx). I focus here specifically on the adoption alternative. Importantly, my purpose is not to oppose UTx provision. Rather, it is to propose ways in which ethical analysis and provision of UTx can potentially accommodate the concerns discussed here. I argue that the adoption alternative to UTx is too readily dismissed, and that this is a dismissal with significant moral costs. I suggest that the radical nature of UTx as a form of assisted reproduction calls for an equivalently radical socio-moral agenda for reform and transformation of adoption law, policy and practice, as well as of the norms that prevail within our presently strongly bio-normative reproductive context...
July 20, 2018: Bioethics
Elliott G Richards, Rebecca Flyckt, Andreas Tzakis, Tommaso Falcone
OBJECTIVE: To demonstrate our technique of uterine procurement from a deceased donor. DESIGN: This video uses live action footage from surgery and detailed illustrations to review the steps and techniques involved in deceased donor procurement surgery. SETTING: Academic medical center. PATIENT(S): A deceased multiorgan donor. INTERVENTION(S): Trial organ procurement of a viable uterus from a deceased donor...
July 1, 2018: Fertility and Sterility
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