Castellón Luis Arturo Ruvalcaba, Amador Martha Isolina García, González Roberto Enrique Díaz, Eduardo Montoya Sarmiento Jorge, Díaz-García César, Kvarnström Niclas, Bränström Mats
Mexican Infertility Institute [Instituto Mexicano de Infertilidad (imi)], Guadalajara, Jalisco-Mexico.
Department of Gynecology and Obstetrics, La Fe University Hospital, University of Valencia, Valencia, Spain.
JBRA Assist Reprod. 2017 Jun 1;21(2):126-134. doi: 10.5935/1518-0557.20170028.
This paper aimed to describe the basic aspects of uterine transplant (UTx) research in humans, including preliminary experiences in rodents and domestic species. Studies in rats, domestic species, and non-human primates validated and optimized the UTx procedure in terms of its surgical aspects, immunosuppression, rejection diagnosis, peculiarities of pregnancy in immunosuppressed patients, and patients with special uterine conditions. In animal species, the first live birth from UTx was achieved in a syngeneic mouse model in 2003. Twenty-five UTx procedures have been performed in humans. The first two cases were unsuccessful, but established the need for rigorous research to improve success rates. As a result of a controlled clinical study under a strictly designed research protocol, nine subsequent UTx procedures have resulted in six healthy live births, the first of them in 2014. Further failed UTx procedures have been performed in China, Czech Republic, Brazil, Germany, and the United States, most of which using living donors. Albeit still an experimental procedure in, UTx is the first potential alternative for the treatment of absolute uterine factor infertility (AUFI).
本文旨在描述人类子宫移植（UTx）研究的基本方面，包括在啮齿动物和家养动物中的初步经验。对大鼠、家养动物和非人类灵长类动物的研究在手术方面、免疫抑制、排斥反应诊断、免疫抑制患者及有特殊子宫情况患者的妊娠特点等方面验证并优化了子宫移植手术。在动物物种中，2003年在同基因小鼠模型中首次通过子宫移植实现了活产。人类已进行了25例子宫移植手术。前两例手术未成功，但确立了开展严格研究以提高成功率的必要性。在严格设计的研究方案下进行的一项对照临床研究结果显示，随后的9例子宫移植手术中有6例成功产下健康活婴，首例于2014年诞生。中国、捷克共和国、巴西、德国和美国也进行了一些失败的子宫移植手术，其中大多数使用的是活体供体。尽管子宫移植仍是一种试验性手术，但它是治疗绝对子宫因素不孕症（AUFI）的首个潜在替代方法。
