Brännström Mats
Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg and Stockholm IVF, Sweden.
Curr Opin Organ Transplant. 2015 Dec;20(6):621-8. doi: 10.1097/MOT.0000000000000246.
The recent first live birth after human uterus transplantation (UTx) is a proof-of-concept of UTx as a factual treatment for women with absolute uterine factor infertility. This review summarizes the 15-year-long translational UTx research project, from the beginning in rodents until the first human UTx live birth in 2014. It also gives detailed information about the 11 human UTx cases performed so far.
The first live birth after UTx in any species was demonstrated already in 2003, in the syngeneic mouse model. Subsequent studies, in rats, large domestic species, and in nonhuman primates optimized the UTx procedure in regards to surgery, immunosuppression, rejection diagnosis, and pregnancy. Worldwide, only 11 human UTx attempts have been performed. The first two single cases were unsuccessful and performed with no research preparations. The following nine transplantations were completed within a clinical UTx trial in 2013. So far, four healthy babies have been born from this cohort and additional patients are pregnant.
Uterus transplantation, still at its early experimental stage, has the potential to become the first true treatment for the around 1.5 million women worldwide that are infertile because of absence of the uterus or presence of a nonfunctional uterus.
近期人类子宫移植(UTx)后首例活产证明了UTx作为绝对子宫因素不孕女性切实可行的治疗方法的概念。本综述总结了长达15年的UTx转化研究项目,从最初在啮齿动物中的研究直至2014年首例人类UTx活产。它还提供了迄今为止进行的11例人类UTx病例的详细信息。
2003年在同基因小鼠模型中就已证明了任何物种UTx后的首例活产。随后在大鼠、大型家养动物和非人灵长类动物中的研究在手术、免疫抑制、排斥诊断和妊娠方面优化了UTx程序。在全球范围内,仅进行了11次人类UTx尝试。前两例单例手术未成功且没有进行研究准备。接下来的9例移植在2013年的一项临床UTx试验中完成。到目前为止,该队列中已诞生了4名健康婴儿,还有更多患者已怀孕。
子宫移植仍处于早期实验阶段,有可能成为全球约150万因子宫缺失或子宫无功能而不孕女性的首个真正治疗方法。