Archives of Gynecology and Obstetrics

, Volume 299, Issue 5, pp 1213–1214 | Cite as

Uterus transplantation: advantages and disadvantages of a deceased donor

  • Iori KisuEmail author
  • Kouji Banno
  • Yusuke Matoba
  • Daisuke Aoki
News and Views

Dear Editor,

First successful livebirth following uterus transplantation (UTx) from a deceased donor was recently reported by Ejzenberg et al. [1]. In 2014, Brännström et al. achieved the first successful delivery after UTx from a live donor [2]. To date, more than 50 UTx procedures have been performed worldwide, leading to more than 10 newborns after UTx from live donors. However, the report of successful livebirth after UTx from a deceased donor increases the potential of UTx for women with uterine factor infertility (UFI).

Most UTx procedures use a uterus from a live donor, but living-to-living UTx is a highly invasive surgery. Brännström et al. perfected their surgical technique in animal experiments for more than 10 years and conducted clinical studies of UTx in many women; however, the time of donor surgery in the first trial was still ~ 10 h and the blood loss was high [3]. This is because an extremely precise surgical procedure is required to remove a part of the deep uterine...


Author contributions

IK wrote this comment. KB, YM and DA revised the manuscript. All authors read and approved the final manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare no competing interests.

Human participants or animal experiments

This article does not contain any studies involving human participants or animals.


  1. 1.
    Ejzenberg D, Andraus W, Mendes LRBC, Ducatti L, Song A, Tanigawa R, Rocha-Santos V, Arantes RM, Soares-Jr JM, Serafini PC, Haddad LBP, Francisco RPV, D’Albuquerque LAC, Baracat EC (2018) Livebirth after uterus transplantation from a deceased donor in a recipient with uterine infertility. Lancet 392(10165):2697–2704CrossRefGoogle Scholar
  2. 2.
    Brännström M, Johannesson L, Bokström H, Kvarnström N, Mölne J, Dahm-Kähler P, Enskog A, Milenkovic M, Ekberg J, Diaz-Garcia C, Gäbel M, Hanafy A, Hagberg H, Olausson M, Nilsson L (2015) Livebirth after uterus transplantation. Lancet 385(9968):607–616CrossRefGoogle Scholar
  3. 3.
    Brännström M, Johannesson L, Dahm-Kähler P, Enskog A, Mölne J, Kvarnström N, Diaz-Garcia C, Hanafy A, Lundmark C, Marcickiewicz J, Gäbel M, Groth K, Akouri R, Eklind S, Holgersson J, Tzakis A, Olausson M (2014) First clinical uterus transplantation trial: a six-month report. Fertil Steril 101:1228–1236CrossRefGoogle Scholar
  4. 4.
    Wei L, Xue T, Tao KS, Zhang G, Zhao GY, Yu SQ, Cheng L, Yang ZX, Zheng MJ, Li F, Wang Q, Han Y, Shi YQ, Dong HL, Lu ZH, Wang Y, Yang H, Ma XD, Liu SJ, Liu HX, Xiong LZ, Chen BL (2017) Modified human uterus transplantation using ovarian veins for venous drainage: the first report of surgically successful robotic-assisted uterus procurement and follow-up for 12 months. Fertil Steril 108:346–356CrossRefGoogle Scholar
  5. 5.
    Testa G, McKenna GJ, Gunby RT Jr, Anthony T, Koon EC, Warren AM, Putman JM, Zhang L, dePrisco G, Mitchell JM, Wallis K, Klintmalm GB, Olausson M, Johannesson L (2018) First live birth after uterus transplantation in the United States. Am J Transplant 18:1270–1274CrossRefGoogle Scholar
  6. 6.
    Erman Akar M, Ozkan O, Aydinuraz B, Dirican K, Cincik M, Mendilcioglu I, Simsek M, Gunseren F, Kocak H, Ciftcioglu A, Gecici O, Ozkan O (2013) Clinical pregnancy after uterus transplantation. Fertil Steril 100:1358–1363CrossRefGoogle Scholar
  7. 7.
    Richards EG, Flyckt R, Tzakis A, Falcone T (2018) Uterus transplantation: organ procurement in a deceased donor model. Fertil Steril 110:183CrossRefGoogle Scholar
  8. 8.
    Testa G, Anthony T, McKenna GJ, Koon EC, Wallis K, Klintmalm GB, Reese JC, Johannesson L (2018) Deceased donor uterus retrieval: a novel technique and workflow. Am J Transplant 18:679–683CrossRefGoogle Scholar
  9. 9.
    Chmel R, Novackova M, Janousek L, Matecha J, Pastor Z, Maluskova J, Cekal M, Kristek J, Olausson M, Fronek J (2018) Revaluation and lessons learned from the first 9 cases of a Czech uterus transplantation trial: four deceased donor and 5 living donor uterus transplantations. Am J Transplant. (Epub ahead of print) Google Scholar
  10. 10.
    Johannesson L, Wallis K, Koon EC, McKenna GJ, Anthony T, Leffingwell SG, Klintmalm GB, Gunby RT Jr, Testa G (2018) Living uterus donation and transplantation: experience of interest and screening in a single center in the United States. Am J Obstet Gynecol 218:331.e1–331.e7CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyKeio University School of MedicineTokyoJapan

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