Cleveland Clinic Hope To Be First In US To Conduct Uterus Transplant, A Breakthrough Operation That's Not Without Its Risks

Tiny feet
A uterus transplant could give women without a womb the chance to become pregnant. Torsten Mangner CC BY-SA 2.0

When the first transplant operation was conducted in 1954 by Dr. Joseph Murray and Dr. David Hume at Brigham Hospital in Boston, the doctors had one objective: to save their patient’s life. Today, over 60 years later, doctors hope to not only save lives through transplant surgery but also improve them by transplanting non-vital yet equally important body parts, from limbs to pensises. Now, surgeons at the Cleveland Clinic in Ohio plan to take this procedure one step further by performing the first uterus transplant in U.S. medical history, but the groundbreaking procedure is not without its risks.

In 2011, a team of doctors in Turkey did the unthinkable and successfully transplanted a womb into the body of a woman born without one in an attempt to give her a chance at motherhood. Although the womb eventually had to be removed due to complications, nine womb transplant operations have since been successful, The New York Times reported. The breakthrough operation involves removing a uterus from a donor and carefully implanting it into a woman without a uterus — her condition due to either a birth defect or illness.

Prior attempts at this operation used live donors — five of the nine transplants were between mother and daughter — but the Cleveland team plans on taking organs from deceased donors. This would mean they only need to operate on one living woman. Along with the uterus, the surgeons would also remove part of the donor’s vagina and other tissue needed to attach the uterus to the recipient.

The organ recipients must also meet a number of strict requirements and pass a psychological evaluation before even qualifying for the procedure. Only financially stable women in a committed relationship would be considered for the operation, too. And the women would have to have ovaries in order to take part.  

Despite having a uterus, natural pregnancy wouldn’t be possible since the uterus wouldn’t actually be connected to the fallopian tubes. Instead, candidates would prepare for in-vitro fertilization by receiving a number of hormone shots to stimulate the ovaries and produce multiple eggs. These eggs would then collected, fertilized with their partners’ sperm, and frozen until a donor with a matching blood and tissue type becomes available. Once this occurs, the surgeons will begin attaching the donor organ to the recipient, an operation that takes about five hours. After the operation, the women would then need to wait a year before doctors can try to implant the fertilized embryo.

If and when the woman becomes pregnant, the baby will need to be delivered via C-section before the due date in order to avoid putting the uterus through the strain of labor. So far, four women in Sweden have successfully given birth following the procedure, The Times reported.

For women who choose not to adopt or have a child via surrogacy, the procedure gives them a chance at motherhood. However, it is not without a long list of dangers. Firstly, the actual operation itself is high-risk. Then, once the organ is successfully attached, recipients face the risk of rejection or infection. In Saudi Arabia’s first attempt in 2000, for example, the organ had to be removed due to blood clotting, The Times reported. Again, an organ transplant conducted in Turkey had to be later removed due to infection.

In addition to risk of clotting and infection, women who undergo this operation must take anti-rejection medications to ensure their bodies doesn’t attack the foreign organ. These medications can increase the mother’s risk of preeclampsia, a serious pregnancy complication involving high blood pressure. Mothers who take anti-rejection medications when pregnant are also known to give birth to low-weight babies, although it’s unclear if this is a result of the medication or a preexisting condition in the mother.

However, Dr. Andreas Tzakis, one of the surgeons leading the uterus transplant team at the Cleveland Clinic, told The NY Times that women who take anti-rejection medications for other types of transplants have still been able to give birth to healthy babies, regardless of their medication. In addition, the women chosen to take part in this procedure will be only of peak health, thus reducing their risks of pregnancy complications.

More importantly, the women who are candidates for the operation say the potential outcome of the operation far outdo the risks. “I know there will be people who don’t understand or agree,” one of them told The Times . I crave that experience. I want the morning sickness, the backaches, the feet swelling. I want to feel the baby move. That is something I’ve wanted for as long as I can remember.”

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