In A First, Baby Born From Transplanted Uterus From Dead Donor

The world's first baby born using a womb transplanted from a dead woman is a breakthrough in the field of obstetrics and a great advantage for women combating infertility, say Indian doctors.

According to a case study published in The Lancet on Wednesday, a healthy baby girl was born in 2017, following the uterus transplant from a 45-year-old brain dead woman.

The womb transplant, lasting over 10 hours, took place in Sao Paolo in Brazil in September 2016. The baby was born in December 2017.

The uterus was removed from the donor and transplanted into the recipient in a surgery that also involved connecting the donor uterus and recipient's veins and arteries, ligament and vaginal canals.

"It is a breakthrough in the field of obstetrics as well as a great advantage for women who lost their uterus for some reason or don't have from birth. This would increase the availability of the uterus as living donors are always in scarcity," Ranjana Sharma, Senior Consultant, (Obstetrics and Gynaecology), Indraprastha Apollo Hospitals, New Delhi, told IANS.

In a majority of such cases, the uterus does not survive after transplant in the recipient due to infections or rejection by the body's immune system.

But in the case of a uterus transplant from a cadaver, the potential danger for infections is more, says Kamini A. Rao, Medical Director, Milann-The Fertility Centre, Bengaluru.

"One will never be able to find whether the dead woman has had any infections in the uterus, nor in the vaginal canals and whether it is treatable or not," Ms Rao told IANS.

"This is not in the case of a kidney or liver transplant, clearly because the vagina is an exposed area and since you are unable to identify what kind of organisms were growing, there is a potential danger for rejection," Ms Rao added.

Still, the advantage is that the surgery takes place only for a person. It is a very good thing compared to a live donor, she noted.

"When a transplant is dome from a live donor, there is a greater responsibility towards both the donor and recipient, but in a dead body the doctors can be a bit relaxed," Ms Sharma said.

Importantly, in the Lancet case study, the uterus had an interval of eight hours before getting connected to the living body.

"Up till now it was not known that uterus can survive more than four hours out of a living body, however, the present case shows that the uterus is a quite strong an organ," Ms Sharma said.

"Just as cornea, kidney, liver, heart, the pancreas, I am hopeful that the uterus will also be added in the gamut of organs taken out so that many more people will be benefited," Ms Rao noted.

Moreover, the doctors said that while a transplanted kidney or liver stays for life, it is not the case with the uterus.

"This is only to give birth to a child. Once the baby reaches maturity, the uterus is taken out along with the baby. It is because we don't know the long-term effects of having a foreign uterus in the body. So far the uterus has not been left after taking out the baby. It is then discarded, like any hysterectomy," Ms Sharma said.

Besides women who lost uterus or do not have from birth, this kind of transplant could also someday open doors for people who are transgender, Ms Sharma suggested.

"However sometimes you may only have an absent uterus like in this case. But for transgender, you will also have to take the donor eggs, like a surrogate gestation," Ms Rao pointed out.