Cesk Patol. 2022 Spring;58(1):57-60.
Uterus transplantation is a new experimental treatment method of absolute uterine factor infertility which affects 3-5% of infertile women. Absolute uterine factor infertility includes infertile women with agenesis or severe malformation of the uterus, several acquired uterine diseases causing infertility, and patients of fertile age after hysterectomy because of various causes. Uterus transplantation is considered a new method of assisted reproduction which allows women with absolute uterine factor infertility to have own biological offspring. However, uterus transplantation is considered a radical method of reproduction by some ethicists. Nevertheless, recent analysis of newborns from transplanted uterus has shown high level of childbirths of mature and near-to-term newborns and did not confirm increased risk for both babies and mothers. Therefore, together with gestational surrogacy and adoption, uterus transplantation is nowadays considered promising and unique solution for women with absolute uterine factor infertility. Similarly to other solid organ transplants, the pathologist should be an integral part of the multidisciplinary uterus transplantation research teams. The primary role of the pathologist is histopathological evaluation of rejection changes in the biopsy samples from the ectocervix of the uterine allografts that is based on the provisional scoring system suggested by Swedish pioneers in uterus transplantation research. As the word provisional suggests, this scoring system is continuously studied and the principles of the evaluation of rejection after uterus transplantation could be adjusted in the future.
子宫移植是一种治疗绝对子宫因素不孕的新的实验性治疗方法，这种疾病影响了 3-5%的不孕女性。绝对子宫因素不孕包括子宫发育不全或严重畸形、多种导致不孕的后天性子宫疾病，以及因各种原因而在育龄期行子宫切除术的患者。子宫移植被认为是一种辅助生殖的新方法，使患有绝对子宫因素不孕的女性能够拥有自己的亲生子女。然而，一些伦理学家认为子宫移植是一种激进的生殖方法。然而，最近对来自移植子宫的新生儿的分析表明，成熟和接近足月的新生儿的出生率很高，并没有证实母婴双方的风险增加。因此，与代孕和收养一样，子宫移植目前被认为是患有绝对子宫因素不孕的女性的一种有前途的、独特的解决方案。与其他实体器官移植一样，病理学家应该是多学科子宫移植研究团队的一个组成部分。病理学家的主要作用是根据瑞典子宫移植研究先驱提出的暂定评分系统，对来自异体子宫移植物宫颈的活检样本中的排斥反应变化进行组织病理学评估。正如暂定一词所暗示的那样，这个评分系统正在不断研究中，未来可能会调整子宫移植后排斥反应的评估原则。
