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Uterine transplantation

John A Robertson
The birth of a child after uterus transplant from a living donor in Sweden in October, 2013 has spurred reproductive and transplant physicians in Europe and North America to investigate whether uterus transplants, from living or cadaveric donors, will be a safe and effective therapy for women with uterine insufficiency. While progress with uterus transplant depends on medical factors, there are also important ethical and legal concerns. Uterus transplant is essential for women without access to surrogacy. It may also be sought by infertile women who dislike surrogacy...
April 2016: Journal of Law and the Biosciences
Minoo Heidari Kani, Eng-Cheng Chan, Roger C Young, Trent Butler, Roger Smith, Jonathan W Paul
Research insights into uterine function and the mechanisms of labour have been hindered by the lack of suitable animal and cellular models. The use of traditional culturing methods limits the exploration of complex uterine functions, such as cell interactions, connectivity and contractile behaviour, as it fails to mimic the three-dimensional (3D) nature of uterine cell interactions in vivo. Animal models are an option, however, use of these models is constrained by ethical considerations as well as translational limitations to humans...
October 21, 2016: Annals of Biomedical Engineering
Margaret M Brosnahan, Emily J Silvela, Jessica Crumb, Donald C Miller, Hollis N Erb, Douglas F Antczak
Invasive trophoblast from Day-34 horse conceptuses survives in extra-uterine sites in allogeneic recipients that are immunologically naïve to donor major histocompatibility complex class I antigens. The ectopic trophoblast retains its in utero characteristics, including similar lifespan, physiologic effect of its secreted product (equine chorionic gonadotrophin) upon the recipient's ovaries, and induction of host immune responses. Immunologic memory has not been considered previously in this experimental system...
October 19, 2016: Biology of Reproduction
G Testa, E C Koon, L Johannesson
The uterus is the most recent addition to the list of organs that can be successfully transplanted in humans. This paper analyzes living donor uterus transplantation according to the ethical principle of equipoise. A comparison is made between living donor uterus transplantation and gestational surrogate motherhood. Both are solutions to absolute uterine infertility that allow the transfer of genetic material from intended parents to a child. The analysis concludes that living donor uterus transplantation does not violate the ethical principle of equipoise and should be considered an ethically acceptable solution to absolute uterine infertility...
October 18, 2016: American Journal of Transplantation
Jacques Balayla
The uterine transplant is an innovative surgical procedure whereby a healthy uterus is transplanted into a woman with uterine factor infertility (UFI) for the purpose of procreation. Twelve uterine transplants have been attempted in the world in the last two decades, and five have led to viable births. While uterine transplantation is still in its experimental stages, it remains unclear whether Canadian centres plan to attempt the procedure in the near future. Herein, I raise several observations that are specific to the Canadian setting and apply the Montreal Criteria for the Ethical Feasibility of Uterine Transplantation to determine whether there is fertile ground for a uterine transplantation program to be adopted in Canada...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Shinji Yamamoto, Maria Nelander
INTRODUCTION: We present a case report of ectopic pregnancy (EP) after simultaneous pancreas-kidney transplantation (SKPTx). PRESENTATION OF CASE: A 33-year-old female status post SKPTx suddenly got abdominal pain in the lower level. She had high human chorionic Gonadotropin test. Ultrasonography revealed that there was no fetus in the uterus but a dilated right fallopian tube, which strongly suggested ectopic pregnancy. An emergency operation was performed and a dilated right side uterine tube was found with adhesions to her transplant...
September 30, 2016: International Journal of Surgery Case Reports
Patricia Silveira, Camila Texidor-Frugoni, Gaby F Martínez, M Mónica Brauer
Endometriosis is a benign estrogen-dependent chronic gynecological disease characterized by the presence of endometrial-like tissue outside the uterine cavity. In both women and experimental endometriotic rats, endometriosis lesions endow autonomic and sensory nerves, which are thought to contribute to the disease-associated pain. Some evidence indicates that the reinnervation of lesions is regulated by factors produced by the endometrial tissue as well as by environmental factors from the peritoneum. In this study, we examined the reinnervation of the rat endometrial tissue in an ectopic environment different from the peritoneum employing the anterior eye chamber model of experimental endometriosis...
September 23, 2016: Autonomic Neuroscience: Basic & Clinical
Andrea Flesken-Nikitin, Blaine A Harlan, Alexander Yu Nikitin
Orthotopic transplantation assays in mice are invaluable for studies of cell regeneration and neoplastic transformation. Common approaches for orthotopic transplantation of ovarian surface and tubal epithelia include intraperitoneal and intrabursal administration of cells. The respective limitations of these methods include poorly defined location of injected cells and limited space volume. Furthermore, they are poorly suited for long-term structural preservation of transplanted organs. To address these challenges, we have developed an alternative approach, which is based on the introduction of cells and tissue fragments into the mouse fat pad...
2016: Journal of Visualized Experiments: JoVE
E R Ramirez, M Ehrenburg, R Silver, S J Churchill, H A Ramirez
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
E R Ramirez, M Ehrenburg, R Silver, S J Churchill, H A Ramirez
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
J Zhao, B Xu, S Xie, Q Zhang, Y P Li
BACKGROUND: Previous studies have explored the effect of granulocyte colony stimulating factor (G-CSF) administration on the outcome of assisted reproductive technology (ART), and came into controversial conclusions. The present meta-analysis aims to assess whether G-CSF administration has beneficial effect on the outcome after ART. METHOD: The electronic databases Pubmed, Embase and Google Scholar were searched up to May 2016. Articles that studied the effect of G-CSF administration on the outcome after ART were included in the present meta-analysis...
2016: Reproductive Biology and Endocrinology: RB&E
J Froněk, L Janousek, R Chmel
INTRODUCTION: Uterus transplantation is the youngest solid organ transplantation described in the literature. This procedure is the only treatment method for congenital or acquired Absolute Uterine Factor Infertility. METHOD: The method is not recognised as standard clinical care yet, there were only some 13 cases performed worldwide so far. There is only one clinical trial worldwide, which has proven both feasibility and also healthy child delivery. RESULTS: Czech Republic Ministry of Health permitted the uterus transplant clinical trial in 2015...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Tristan Gauthier, Matthieu Filloux, Angelique Guillaudeau, Marie Essig, Romain Bibes, Adam Fodil Pacha, Pascal Piver, Yves Aubard, Pierre Marquet, Mireille Drouet
AIM: To describe class I and II human leucocyte antigen (HLA) expression using different uterine tissues in the perspective of uterus transplantation. METHODS: Human uterine tissues were obtained from 12 women who had undergone hysterectomy for the treatment of benign disease. HLA class I and HLA-antigen D related (DR) expression were assessed via immunochemistry. HLA class I expression in the uterus was compared with expression in other organs and tissues, including kidney and myocardium samples...
September 19, 2016: Journal of Obstetrics and Gynaecology Research
Omer Ozkan, Nasuh Utku Dogan, Ozlenen Ozkan, Inanc Mendilcioglu, Selen Dogan, Batu Aydinuraz, Mehmet Simsek
Absolute uterine factor infertility affects 3-5% of the general population, and unfortunately this condition is untreatable. There are some available options, including surrogacy or adoption, but neither of these suits each and every woman who desires to have her own genetic child. With recent advances in surgery and transplant immunology, uterus transplantation may be a source of hope for these women with uterine infertility. In the last decade, a number of animal species including rats, mice, rabbits, pigs, sheep, and primates have been used as experimental models, and pregnancies were achieved in some of these...
July 2016: Women's Health
Rebecca L Flyckt, Ruth M Farrell, Uma C Perni, Andreas G Tzakis, Tommaso Falcone
This commentary endeavors to share our practical experience in developing and implementing the first uterine transplant clinical trial in the United States. Uterine transplant is a promising novel treatment for uterine factor infertility. After reported successful live births after uterine transplant in Sweden, research teams around the world are either embarking on or are considering the development of uterine transplant protocols. Our observations on the applied rather than theoretical aspects of uterine transplantation research in human subjects are detailed in this article...
October 2016: Obstetrics and Gynecology
Vincent Lavoué, Cécile Vigneau, Solène Duros, Karim Boudjema, Jean Levêque, Pascal Piver, Yves Aubard, Tristan Gauthier
BACKGROUND: The aim of this systematic review was to evaluate and compare the pros and cons of using living donors or brain-dead donors in uterus transplantation programs, 2 years after the first worldwide live birth after uterus transplantation. METHODS: The Medline database and the Central Cochrane Library were used to locate uterine transplantation studies carried out in human or non-human primates. All types of articles (case reports, original studies, meta-analyses, reviews) in English or French were considered for inclusion...
September 8, 2016: Transplantation
Teruyuki Mizutani, Osamu Yamamuro, Noriko Kato, Kazumasa Hayashi, Junya Chaya, Norihiko Goto, Toyonori Tsuzuki
•We analyzed the epidemiological factors for clinical manifestations of uterine adenomatoid tumors.•Renal transplantation with immunosuppression therapy is risk factor for the development of uterine adenomatoid tumors.•The length of time on dialysis is risk factor for the development of uterine adenomatoid tumors.
August 2016: Gynecologic Oncology Reports
S Huet, A Tardieu, M Filloux, M Essig, N Pichon, J F Therme, P Piver, Y Aubard, J M Ayoubi, O Garbin, P Collinet, A Agostini, V Lavoue, A Piccardo, T Gauthier
OBJECTIVE: Uterine infertility (UI), which can be caused by a variety of congenital or acquired factors, affects several thousand women in Europe. Uterus transplantation (UTx), at the current stage of research, offers hope for these women to be both the biological mother and the carrier of their child. However, the indications of UTx still need to be defined. The main aim of the study was to describe the different etiologies of UI and other data as marital and parental status from women requesting UTx who contacted us in the framework of a UTx clinical trial...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Stacy L McAllister, Barbra K Giourgas, Elizabeth K Faircloth, Emma Leishman, Heather B Bradshaw, Eric R Gross
Endometriosis is a painful condition characterized by growth of endometrial cysts outside the uterus. Here, we tested the hypothesis that peripheral innervation and prostaglandin levels contribute to endometriosis-associated pain. Female Sprague-Dawley rats (n = 16) were surgically instrumented by transplanting uterine tissue onto mesenteric arteries within the peritoneal cavity to create a model of endometriosis which forms extra-uterine endometrial cysts and vaginal hyperalgesia. Our results describe a significant positive correlation between endometriosis-induced vaginal hyperalgesia and cyst innervation density (sensory, r = 0...
December 5, 2016: Molecular and Cellular Endocrinology
N Mazanowska, D Rajski, B Pietrzak, P Kaminski, M Wielgos
BACKGROUND: Pathological changes of uterine adnexa are frequently encountered in patients after solid-organ transplantation. The aim of the study was to evaluate the incidence of malignancies among recipients operated with the diagnosis of adnexal tumor with or without clinical symptoms. METHODS: We retrospectively analyzed data from 146 solid-organ recipients who underwent surgery in the First Department of Obstetrics and Gynecology, Medical University of Warsaw, in the years 2000 to 2014...
June 2016: Transplantation Proceedings
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