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中国子宫移植的临床应用:需考虑的问题。

Clinical applications of uterus transplantation in China: Issues to take into consideration.

作者信息

Liu Yu, Zhang Ying, Ding Yan, Chen Gaowen, Zhang Xuyin, Wang Yifeng, Hua Keqin

机构信息

Department of Gynecology, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

Department of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.

出版信息

J Obstet Gynaecol Res. 2020 Mar;46(3):357-368. doi: 10.1111/jog.14199. Epub 2020 Jan 29.

Abstract

Uterus transplantation (UTx) is an emerging surgical treatment for patients with absolute uterine factor infertility. However, the initial low surgical success of human UTx from the teams worldwide has revealed the difficulty of the surgery and called for preparatory team training in large animals. Also, the team who carried out the human UTx without previous systematic research in large animals or deceased donors encountered transplant failures, which was controversial and even deprived them of further trials. Various UTx studies in large animals, including dogs, pigs, sheep and macaques have been performed in China from different teams, compared to other countries around the world. However, among over 70 UTx that have been carried out worldwide, only three were carried out in China, with one live baby achieved. In this paper, we explore the possible challenges for human UTx in China. We conclude that it is critical to learn the lessons from the international team and adopt the international ethic views regarding UTx on humans. Also, it would be positive for the Chinese groups to establishing an academic society for UTx with regular meetings, which will raise public awareness of UTx, and guide the proper development of human UTx in China.

摘要

子宫移植(UTx)是一种针对绝对子宫因素不孕症患者的新兴外科治疗方法。然而,全球各团队开展的人类子宫移植手术最初成功率较低,这揭示了该手术的难度,并呼吁在大型动物身上进行预备团队培训。此外,那些在未对大型动物或已故供体进行过系统研究的情况下就开展人类子宫移植手术的团队遭遇了移植失败,这引发了争议,甚至导致他们无法进行进一步的试验。与世界其他国家相比,中国不同团队已在包括狗、猪、羊和猕猴等大型动物身上开展了各种子宫移植研究。然而,在全球已进行的70多例子宫移植手术中,只有3例在中国进行,其中一例成功诞下活体婴儿。在本文中,我们探讨了中国开展人类子宫移植手术可能面临的挑战。我们得出结论,从国际团队吸取经验教训并采纳关于人类子宫移植的国际伦理观点至关重要。此外,中国团队成立一个定期召开会议的子宫移植学术协会将是积极有益的,这将提高公众对子宫移植的认识,并引导中国人类子宫移植手术的正确发展。

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