Rejection Diagnosis After Uterus Transplantation
Histopathology is currently the gold standard to diagnose rejection in transplanted organs. In contrast to other solid transplants, there is yet no knowledge about laboratory parameters or early clinical signs that may indicate rejection after uterus transplantation. However, the graft after uterus transplantation can be monitored by histological analysis of ectocervical biopsies. These biopsies are easily accessible at a standard gynecological examination, without putting the patient or graft at risk. Protocol biopsies are taken at regular time intervals after transplantation with subsequent follow-up biopsies in case of rejection to monitor treatment. We have developed and published a grading system for diagnosis of rejection on uterus transplantation biopsies, and this has been successfully applied during the initial Swedish trial with live donor transplantation and during the ongoing robotic-assisted uterus transplantation trial.