Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany.
Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, Germany.
Fertil Steril. 2019 Jan;111(1):186-193. doi: 10.1016/j.fertnstert.2018.09.010.
To report our experience with the screening and selection of potential recipients and living donors of our uterus transplantation (UTx) program.
Part of an observational program.
University hospital.
PATIENT(S): Patients with absolute uterine factor infertility (AUFI).
INTERVENTION(S): Screening by e-mail and telephone, selection during surgical consultation, and preoperative investigations according to a multistep procedure for living donation.
MAIN OUTCOME MEASURE(S): Age, cause of AUFI, exclusion reasons, and preoperative workup.
RESULT(S): A total of 212 potential recipients expressed interest in participation. Among the 46 potential recipients and 49 directed donors were 4 potential recipients, each with 2 directed donors. Mean (range) age of potential recipients was 29.6 (19-41) years. Of the potential recipients, 39 (84.8%) had congenital AUFI and 7 (17.3%) had acquired AUFI. Ultimately, 15 potential recipients with 16 directed donors were selected for participation, with 1 potential recipient having 2 directed donors. Mean age of included potential recipients was 28.9 (22-35) years, and mean donor age was 51.3 (37-62) years. Fourteen potential recipients (93.3%) had congenital AUFI, and one potential recipient (6.7%) had undergone hysterectomy for obstetric complications.
CONCLUSION(S): The number of potential candidates for UTx is not inconsiderable, with congenital AUFI being the leading cause of AUFI in our cohort. However, our findings highlight that large numbers of AUFI patients need to be screened, considering our exclusion rates were >50%, owing to ABO incompatibility, unavailability of a directed donor, and self-withdrawal. Moreover, meticulous preoperative screening, including in-depth psychological assessment, is mandatory to maximize living donor safety and UTx success.
报告我们在子宫移植（UTx）计划中对潜在受者和活体供者进行筛查和选择的经验。
观察性研究的一部分。
大学医院。
绝对子宫因素不孕（AUFI）患者。
通过电子邮件和电话进行筛查，在手术咨询期间进行选择，并根据活体供者的多步骤程序进行术前检查。
年龄、AUFI 病因、排除原因以及术前检查。
共有 212 名潜在受者表示有兴趣参与。在 46 名潜在受者和 49 名定向供者中，有 4 名潜在受者，每名受者各有 2 名定向供者。潜在受者的平均（范围）年龄为 29.6（19-41）岁。其中 39 名（84.8%）为先天性 AUFI，7 名（17.3%）为获得性 AUFI。最终，有 15 名潜在受者和 16 名定向供者入选参与，其中 1 名潜在受者有 2 名定向供者。纳入的潜在受者平均年龄为 28.9（22-35）岁，供者平均年龄为 51.3（37-62）岁。14 名潜在受者（93.3%）为先天性 AUFI，1 名受者（6.7%）因产科并发症而行子宫切除术。
UTx 的潜在候选者数量不少，先天性 AUFI 是我们队列中 AUFI 的主要病因。然而，我们的发现表明，需要对大量的 AUFI 患者进行筛查，因为我们的排除率>50%，原因是 ABO 不合、没有定向供者以及自身撤回。此外，为了最大限度地提高活体供者的安全性和 UTx 的成功率，必须进行细致的术前筛查，包括深入的心理评估。
