Context: Currently, the only 2 options that women with absolute uterine factor infertility have for managing their infertility are surragocy or adoption. These women may also benefit from a possible future third option: uterine transplant.
Objective: To investigate the opinions and views of UK health care professionals toward uterine transplant and rank issues related to uterine transplant by importance in order to make uterine transplant transparent and understandable to colleagues.
Design: Large, in-depth survey investigating health care professionals' opinions on uterine transplant.
Setting: Analysis done at Imperial College London.
Participants: UK transplant professionals (surgeons, nurses, operating room staff, and donor coordinators) and obstetricians and gynecologists (trainees, members, and fellows of the Royal College of Obstetricians and Gynaecologists).
Intervention: Questionnaires were given out at hospital grand rounds, trainee teaching days, and conferences (national and international).
Main Outcome Measures: Should uterine transplant take place? Is uterine transplant achievable? What is the rank order of importance of key issues related to uterine transplant?
Results: The study had 528 participants. With respect to overall support for uterine transplant and as a possible future therapeutic option for absolute uterine factor infertility, 93.8% (n=495) thought that uterine transplant should take place if considered appropriate medically, surgically, and ethically and 57.2% (n=302) thought it was an achievable objective. Issues related to immunology of uterine transplant and pregnancy after uterine transplant were unanimously thought of as most important. More effort is required to educate health care professionals about all aspects of uterine transplant.
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http://dx.doi.org/10.7182/pit2015552 | DOI Listing |
Acta Obstet Gynecol Scand
January 2025
Department of Gynecology, Rennes University Hospital, Hôpital Sud, Rennes, France.
Introduction: Graft optimization is a necessity in order to develop uterus transplantation from brain-dead donors, as a complement to living donors, as these grafts are rare and the last organs retrieved in multiple organ donation. The aim of this study was to assess the feasibility and interest of hypothermic machine perfusion (HMP) in uterus transplantation using a porcine model; secondary outcomes were the evaluation of the graft's tolerance to a prolonged cold ischaemia time and to find new biomarkers of uterus viability.
Material And Methods: Fifteen uterus allotransplantations were performed in a porcine model, after 18 h of cold ischaemia, divided in three groups: Static cold storage in a HTK solution, HMP (with the VitaSmart (™) machine Bridge to Life Ltd.
We examined the risk of subsequent malignant neoplasms (SMNs) in 1720 patients with hematologic cancers given allogeneic hematopoietic grafts from 03/1998 to 08/2023 after nonmyeloablative conditioning regimens. With a median follow-up of 12 years, the cumulative incidence of SMNs was 17% (95% CI, [15%, 19%]). Most SMNs (n = 543) were non-melanoma skin cancers seen in 208 patients; unfortunately, information on these cancers was not available in the Surveillance, Epidemiology, and End Results (SEER) database for comparison with such tumors in the general population.
View Article and Find Full Text PDFAsian J Endosc Surg
January 2025
VM Medicalpark Florya Hospital, İstanbul Aydın University, İstanbul, Turkey.
This study demonstrates the feasibility of performing a Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) hysterectomy on a patient with a complex surgical history, including two renal transplants. The case involves a 42-year-old female presenting with persistent menorrhagia and hypermenorrhea, unresponsive to standard treatments, and diagnosed with adenomyosis and CIN3. A detailed, step-by-step procedure of the vNOTES technique is provided, marking the first video article to document vNOTES hysterectomy in such a medical context.
View Article and Find Full Text PDFAm J Reprod Immunol
February 2025
GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands.
Problem: Natural killer (NK) cells undergo education for full functionality via interactions between killer immunoglobulin-like receptors (KIRs) or NKG2A and human leukocyte antigen (HLA) ligands. Presumably, education is important during early pregnancy as insufficient education has been associated with impaired vascular remodeling and restricted fetal growth in mice. NK cell education is influenced by receptor co-expression patterns, human cytomegalovirus (CMV), the HLA-E107 dimorphism, and HLA-B leader peptide variants.
View Article and Find Full Text PDFFertil Steril
January 2025
The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA.
Importance: Patients with uterine factor infertility (UFI) have few options for family building. Uterus transplant is a feasible treatment for some patients; however, cost remains a significant concern.
Objective: To compare the cost effectiveness of treatment for patients with absolute uterine factor infertility to achieve 1-2 singleton births by gestational carrier or uterus transplant DESIGN: Decision analysis from the United States healthcare sector perspective, with time horizons to achieve one or two singleton births.
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