3 out of 4 utereus transplants from live donors fail

Poor blood flow cited as reason

Texas doctors have done the first womb transplants using live donors in the United States.

Four women who had been born without a uterus received one in operations last month at Baylor University Medical Center at Dallas. Three of the wombs have had to be removed because of poor blood flow. But the hospital said in a statement Wednesday that the fourth recipient still has hers and is showing no signs of rejection.

The hospital would not identify any of the donors or recipients.

There have been at least 16 previous uterus transplants worldwide, including one in Cleveland from a deceased donor that had to be removed because of complications. Two doctors from the University of Gothenburg in Sweden, which has done the most of these operations, were in Dallas to assist with the four transplants there.

At least five births have resulted from the womb transplants in Sweden. Dallas doctors are hopeful the patient who still has her transplanted womb will become the first successful case in the U.S. She is part of a clinical trial that Baylor announced in January that aims to enrol 10 women born without a uterus or with a faulty one.

Womb donors can be dead or alive, and the Baylor study aims to use some of both. The first four cases involved “altruistic” donors — unrelated and unknown to the recipients, a hospital spokesman said. The ones done in Sweden were from live donors, mostly from the recipients’ mother or a sister.

Doctors hope that womb transplants will enable as many as several thousand women born without a uterus to bear children. To be eligible for the Baylor study, women must be 20 to 35 years old and have healthy, normal ovaries. They will first have in vitro fertilization to retrieve and fertilize their eggs and produce embryos that can be frozen until they are ready to attempt pregnancy.

After the uterus transplant, the embryos can be thawed and implanted, at least a year after the transplant to make sure the womb is working well. A baby resulting from a uterine transplant would be delivered by cesarean section. The wombs are not intended to be permanent — having one means a woman must take powerful drugs to prevent organ rejection, and the drugs pose long-term health risks, so the uterus would be removed after one or two successful pregnancies.

Womb transplants are one of many newer trends in a field that has advanced many frontiers in recent years. On Wednesday, doctors at Brigham and Women’s Hospital in Boston said they performed a double-arm transplant for a retired Marine sergeant who lost all four limbs to a bomb in Afghanistan. It was not a first, even for the hospital — at least 85 hand or arm transplants have been done globally since the first one nearly two decades ago.

Doctors from Houston Methodist Hospital and MD Anderson Cancer Center in 2014 did the world’s first partial skull and scalp transplant to help a man who suffered a large head wound from cancer treatment. More than two dozen face transplants have been done since the first one in France in 2005 the first one in the U.S. was done in Cleveland in 2008.

A host of patients have received transplants or implants of 3-D printed body parts, ranging from blood vessels to windpipes.

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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