Transplanting success into medical confidence

By | Science & Technology
Schematic drawing of the vessel connections of the transplanted uterus. Credit@thelancet.

The science community celebrated a medical first last month when a child was born using a transplanted womb. A 36 year old Swedish mother gave birth to a healthy baby boy named Vincent. Many doctors and couples around the world have been given confidence in the procedure, which is currently in its experimental phase. Transplant surgery has become more complex over the past few decades with hands, faces and a variety of organs being replaced, allowing doctors to treat a variety of conditions. However, this is the first successful case of a uterine transplant producing a child.

The child was delivered through cesarean by Dr. Mats Brannstrom, a professor of obstetrics and gynecology at the University of Gothenburg and Stockholm IVF. Dr. Brannstrom and colleagues performed womb transplants on eight other women over the past two years – the majority in their 30s. Dr. Brannstrom’s womb transplant study developed, and seven of the nine women had fertilised eggs transferred into the uterine lining. Two more pregnancies are allegedly 25 weeks into development in this study.

The newborn baby just after birth Credit@thelancet.

The newborn baby just after birth. Credit@thelancet.

The transplant operation involves lifting the donor’s organ into the recipient where it takes 20 – 40 minutes before the new blood circulation begins to function. The womb is then fixed within the pelvis. The uterus was donated last year by a close family friend. The 61 year old donor had given birth to two children herself and been through the menopause. The birth demonstrated that the donor’s womb was clearly still capable of nourishing a child during pregnancy. Once the operation is complete Dr. Brannstrom and his team check the patient for immunosuppression, to ensure the organ is safely accepted by the body. After a year, fertilised eggs collected before the operation, are then planted into the uterus.

There have been a number of attempts to transplant a womb, each building on scientist’s knowledge of uterine transplants. Trials in both Saudi Arabia and Turkey have proved useful lessons in the lead up to Dr. Brannstrom’s study. A successful uterine transplant was performed on a mouse by a PhD student of Brannstrom’s during the research prior to the human trail in Sweden. This procedure resulted in the birth of healthy offspring. Following this research continued and tests were performed on larger animals, until the team performed the transplant on a baboon. Once the procedure was determined safe and ethical, Dr. Brannstrom was able to perform the operation on the 9 women. This scientific research has led to Dr. Brannstrom’s current procedure, which has further expanded the medical knowledge on uterine transplants and proved the procedure to be a success.

The experimental nature of the procedure meant it was challenging for both the doctors and parents involved. However, this success may lead to more uterine transplants around the world, including planned procedures in the UK. Dr. Brannstrom has published the results of his work in the medical journal Lancet. He also held the first workshop on human uterine transplantation in February to help other doctors perform a similar procedure. This aims to help them replicate this treatment for other women.

This medical first provides new insight for many women who are challenged in conceiving children. This case provides clear evidence that a uterine transplant may be successful through continual medical support and research. Dr. Brannstrom’s study was carefully planned to meet safe, ethical guidelines to provide women with the opportunity to give birth to a child. Baby Vincent is a symbol of great possibilities for women in a similar position.

How might this success bring confidence to other transplant procedures?

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