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子宫移植:从实验性手术到临床手术的转变。

Uterus transplantation: transition from experimental to clinical procedure.

作者信息

Brännström Mats

机构信息

Department of Obstetrics and Gynecology, University of Gothenburg, Gothenburg, Sweden -

Stockholm IVF-EUGIN Clinic, Stockholm, Sweden -

出版信息

Minerva Ginecol. 2019 Dec;71(6):460-466. doi: 10.23736/S0026-4784.19.04482-4.

Abstract

Uterus transplantation is a novel treatment to treat uterine factor infertility. This type of infertility is due to absence of an anatomical or functional uterus. This review covers important research findings in the field, and this research formed the base for introduction of uterus transplantation as an experimental clinical procedure. The basic animal-research investigated central facets such as surgery, immunosuppression, ischemia-reperfusion injury, rejection, and fertility. The first clinical uterus transplantation trial was started in 2013 and this was a live donor trial. The first live birth was reported in 2014 and this has been followed by a number of births from the initial trial in Sweden and in several other parts of the world. The uterus transplantations procedures and the live births that have been scientifically reported will be discussed in this review. Lastly, some aspects for an efficient transition from an experimental phase into a clinical phase of uterus transplantation will be discussed.

摘要

子宫移植是治疗子宫因素不孕症的一种新疗法。这类不孕症是由于解剖学意义上的子宫缺失或子宫功能异常所致。本综述涵盖了该领域的重要研究发现,这些研究为子宫移植作为一种实验性临床手术的引入奠定了基础。基础动物研究调查了诸如手术、免疫抑制、缺血再灌注损伤、排斥反应和生育能力等核心方面。首例临床子宫移植试验于2013年启动,这是一项活体供体试验。2014年报道了首例活体分娩,随后瑞典的初始试验以及世界其他几个地区也有了多例分娩。本综述将讨论科学报道的子宫移植手术和活体分娩情况。最后,还将讨论子宫移植从实验阶段高效过渡到临床阶段的一些方面。

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