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Uterus transplantation

I Kisu, K Banno, Y Matoba, M Adachi, D Aoki
Uterus transplantation (UTx) has become an alternative to gestational surrogacy and adoption for women with uterine factor infertility (UFI). Brännström et al achieved the first human delivery after UTx in 2014, and to date a total of 8 babies have been born after UTx from living donors. This outcome has attracted much attention worldwide, and many countries are now preparing for UTx. There are an estimated 60,000 women of reproductive age with UFI in Japan, and these patients cannot have biological children because gestational surrogacy is forbidden in Japan...
March 19, 2018: Transplantation Proceedings
Lars Sandman
Researchers have recently provided proof of concept for uterus transplantation, giving rise to a discussion about priority setting. This article analyses whether absolute uterine-factor infertility (AUFI), the main indication for uterus transplantation, gives rise to a healthcare need and the extent to which such a need places justified claims on public funding in a needs-based welfare system. It is argued that, regardless of the concept of health to which one subscribes, there is a healthcare need for uterus transplantation in women with AUFI...
October 2018: Bioethics
Emily McTernan
Uterus transplants provide another treatment for infertility. Some might think that we should embrace such transplants as one more way to assist people to have children. However, in this paper I argue that uterus transplants are not something that we ought to fund, nor something that we should make easy to access. First, I argue that any justification of providing uterus transplants must be based on the value of the experience of gestation, rather than on claims of meeting medical need or promoting normal functioning...
October 2018: Bioethics
Nicola Jane Williams, Rosamund Scott, Stephen Wilkinson
No abstract text is available yet for this article.
October 2018: Bioethics
Laura O'Donovan
Over the course of recent years, various scientific advances in the realm of reproduction have changed the reproductive landscape, enhancing women's procreative rights and the choices available to them. Uterus transplants (UTx) are the latest of such medical innovations aimed at restoring fertility in women suffering from absolute uterine factor infertility, providing them with the possibility not only of conceiving a genetically related child but also of gestating their own pregnancies. This paper critically examines the primacy of reproductive liberty in the context of uterus transplantation...
October 2018: Bioethics
Antoine Tardieu, Ludivine Dion, Pierre Collinet, Jean Marc Ayoubi, Olivier Garbin, Aubert Agostini, Yves Aubard, Pascal Piver, Vincent Lavoué, Tristan Gauthier
No abstract text is available yet for this article.
October 11, 2018: Journal of Gynecology Obstetrics and Human Reproduction
Ludivine Dion, Antoine Tardieu, Olivier Garbin, Jean Marc Ayoubi, Aubert Agostini, Pierre Collinet, Aubard Yves, Piver Pascal, Gauthier Tristan, Vincent Lavoué
No abstract text is available yet for this article.
September 26, 2018: Journal of Gynecology Obstetrics and Human Reproduction
L Dion, A Tardieu, P Piver, Y Aubard, J M Ayoubi, O Garbin, A Agostini, P Collinet, T Gauthier, V Lavoué
No abstract text is available yet for this article.
September 26, 2018: Journal of Gynecology Obstetrics and Human Reproduction
Vincent Lavoué, Ludivine Dion, Antoine Tardieu, Olivier Garbin, Jean Marc Ayoubi, Aubert Agostini, Pierre Collinet, Pascal Piver, Yves Aubard, Tristan Gauthier
Absolute uterine factor infertility affects several thousand young women in France. The first healthy child delivered to a uterus transplant recipient took place in 2014, and uterus transplantation is developing rapidly in many countries. The French College of Gynaecologists and Obstetricians (CNGOF) formed a uterus transplantation committee (CETUF) in 2015 to advance this technology in France. The CETUF sets out the criteria for the designation of Uterus Transplantation Centres. The objectives, requirements, operation and responsibilities of these centres have been described...
September 25, 2018: Journal of Gynecology Obstetrics and Human Reproduction
Anna Egorova, Mariya Petrosyan, Marianna Maretina, Natalia Balashova, Lyudmila Polyanskih, Vladislav Baranov, Anton Kiselev
Development of gene therapy for endometriosis requires inhibition of vascularization in endometrial lesions. We have previously developed CXCR4 receptor-targeted siRNA carrier L1 and observed efficient RNAi-mediated down-regulation of VEGFA gene expression in endothelial cells followed by decrease in VEGFA protein production and inhibition of cell migration. In this study we evaluated L1 carrier as non-viral vector for anti-VEGFA siRNA delivery into endometrial implants in rat subcutaneous endometriosis model created by subcutaneous auto-transplantation of uterus horn's fragments...
September 25, 2018: Gene Therapy
Xavier Santamaria, Aymara Mas, Irene Cervelló, Hugh Taylor, Carlos Simon
BACKGROUND: Stem cell research in the endometrium and myometrium from animal models and humans has led to the identification of endometrial/myometrial stem cells and their niches. This basic knowledge is beginning to be translated to clinical use for incurable uterine pathologies. Additionally, the implication of bone marrow-derived stem cells (BMDSCs) in uterine physiology has opened the field for the exploration of an exogenous and autologous source of stem cells. OBJECTIVE AND RATIONALE: In this review, we outline the progress of endometrial and myometrial stem/progenitor cells in both human and mouse models from their characterization to their clinical application, indicating roles in Asherman syndrome, atrophic endometrium and tissue engineering, among others...
November 1, 2018: Human Reproduction Update
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
Although 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 4 deceased donor and 5 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...
October 2018: Journal of Surgical Oncology
Wida S Cherikh, Linda C Cendales, Christopher L Wholley, Jennifer Wainright, Vijay S Gorantla, David K Klassen, Sue V McDiarmid, Lawrence 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 United States. As of December 31, 2017, 61 VCA programs at 27 centers were approved in the United States. 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
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