Chmel Roman, Nováčková Marta, Pastor Zlatko, Matěcha Jan, Čekal Miloš, Froněk Jiří
Cas Lek Cesk. 2017 Winter;156(1):36-42.
Uterus transplantation is an experimental treatment method with an ambition to become accepted treatment modality for women with absolute uterine factor infertility. The only legal alternative for these women to get parenthood is adoption which is accepted by most world societies and countries. Surrogate pregnancy is connected with many medical, ethical, legal, religious and social controversies in the great part of the world.Donors (in living donation), recipients, partners and also unborn children must be incorporated into the analysis of ethical risks and benefits of uterus transplantation. The main ethical risks for the recipient are surgery, immunosuppression, pregnancy and delivery. All the potential recipients have to be advised about further ethical issues like organ rejection, infection, side effects of the drugs, unsatisfactory fertilization and different complications during pregnancy.Uterus procurement in donor takes longer time than in standard hysterectomy due to preparation of uterine arteries and veins. Vessels with 2 mm diameter and their anatomical collision with ureter are connected with higher peroperative risk of uneventful surgical complications. Ethical issues might be connected with the uterus procurement in dead brain donors identically.The deliveries after uterus transplantation are fruitful but the risk of preterm delivery and immaturity of the newborns cannot be underestimated as well.
子宫移植是一种实验性治疗方法，旨在成为治疗绝对子宫因素不孕症女性的被认可的治疗方式。这些女性获得亲生孩子的唯一合法替代办法是收养，这在世界上大多数社会和国家都被接受。在世界大部分地区，代孕与许多医学、伦理、法律、宗教和社会争议相关。捐赠者（活体捐赠）、接受者、伴侣以及未出生的孩子都必须纳入子宫移植伦理风险和益处的分析之中。接受者面临的主要伦理风险包括手术、免疫抑制、怀孕和分娩。必须向所有潜在接受者告知进一步的伦理问题，如器官排斥、感染、药物副作用、受精不理想以及怀孕期间的各种并发症。由于要准备子宫动静脉，从捐赠者获取子宫比进行标准子宫切除术耗时更长。直径为2毫米的血管及其与输尿管的解剖学碰撞会带来更高的手术平稳期并发症手术风险。在脑死亡捐赠者身上获取子宫同样可能存在伦理问题。子宫移植后的分娩是成功的，但早产和新生儿不成熟的风险也不可低估。
