College of Animal Science and Technology, China Agricultural University, Beijing 100193, China.
CAS Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, 100101 Beijing, China.
Transpl Immunol. 2020 Dec;63:101335. doi: 10.1016/j.trim.2020.101335. Epub 2020 Sep 11.
Uterine transplantation (UTx) is the only effective treatment for uterine infertility patients to become genetic mothers. After decades of research, the surgical methods of UTx are very developed. There are numerous factors that affect the results of UTx, such as selection of the donor uterus before transplantation, immunosuppressive therapy post-transplantation, rejection monitoring, and immune tolerance. Studies have shown that immune rejection is a crucial factor affecting the survival rate after organ transplantation. Unlike liver or kidney transplantation, the aim of UTx is to obtain a functional uterus that is able to support successful pregnancy and birth of a healthy fetus. Because of the unique purpose of UTx, its immunosuppressive program is relatively specialized. Some immunosuppressive agents can cause perinatal complications, and inducing immune tolerance is necessary to resolve these side effects. Further understanding of the immune mechanism of UTx and the continuous development of new immunosuppressive agents, combined with the application of assisted reproductive technology, will be more conducive to the realization of UTx to breed offspring.
子宫移植(UTx)是子宫性不孕患者成为遗传母亲的唯一有效治疗方法。经过几十年的研究,UTx 的手术方法已经非常发达。有许多因素会影响 UTx 的结果,例如移植前供体子宫的选择、移植后的免疫抑制治疗、排斥反应监测和免疫耐受。研究表明,免疫排斥是影响器官移植后存活率的关键因素。与肝或肾移植不同,UTx 的目的是获得一个能够支持成功妊娠和健康胎儿分娩的功能性子宫。由于 UTx 的特殊目的,其免疫抑制方案相对专业化。一些免疫抑制剂会引起围产期并发症,需要诱导免疫耐受来解决这些副作用。进一步了解 UTx 的免疫机制和不断开发新的免疫抑制剂,并结合辅助生殖技术的应用,将更有利于 UTx 实现生育后代的目标。