Obstetrics and Gynecology Umberto I Hospital, Kore University of Enna, 94100 Enna, Italy.
Obstetrics and Gynecology Giovanni Paolo II Hospital, 97100 Ragusa, Italy.
Medicina (Kaunas). 2024 Aug 19;60(8):1348. doi: 10.3390/medicina60081348.
Uterus transplantation is the surgical treatment for absolute uterine factor infertility (AUFI), a congenital or acquired condition characterized by the absence of a uterus. More than 80 transplants have been performed worldwide, resulting in more than 30 live births, originating both from living and deceased donors. The collection of published articles on deceased donor uterus transplantations was performed in PubMed and SCOPUS by searching for the terms "Uterus transplantation" AND "deceased donor"; from the 107 articles obtained, only case reports and systematic reviews of deceased donor uterus transplantations and the resulting live births were considered for the present manuscript. The extracted data included the date of surgery (year), country, recipient (age and cause of AUFI) and donor (age and parity) details, outcome of recipient surgery (hysterectomy), and live births (date and gestational age). The search of peer-reviewed publications showed 24 deceased donor uterus transplantations and 12 live births (a birth rate of 66%) with a 25% occurrence of graft loss during follow-up (6 of 24). Among this series, twelve transplants were performed in the USA (seven births), five in the Czech Republic (one birth), three in Italy (one birth), two in Turkey (two births), and two in Brazil (one birth). The median recipient age was 29.8 years (range 21-36), while the median donor age was 36.1 years (range 20-57). Of 24 recipients, 100% were affected by MRKH (Mayer-Rokitanski-Kuster-Hauser) syndrome. Two live births were reported from nulliparous donors. Deceased donor uterus transplantation birth rates are very similar to the living donor rates reported in the literature, but ethical implications could be less important in the first group. It is necessary to register every case in the International Registry for Uterus Transplantation in order to perform a systematic review and comparison with living donor rates.
子宫移植是绝对子宫因素不孕（AUFI）的外科治疗方法，AUFI 是一种先天性或获得性疾病，其特征是子宫缺失。全世界已经进行了 80 多次移植，导致 30 多个活产，这些活产源自活体和已故供体。在 PubMed 和 SCOPUS 中通过搜索“子宫移植”和“已故供体”这两个术语，对已故供体子宫移植的已发表文章进行了收集；从获得的 107 篇文章中，仅考虑了已故供体子宫移植和由此产生的活产的病例报告和系统评价，以用于本手稿。提取的数据包括手术日期（年份）、国家、受者（年龄和 AUFI 原因）和供者（年龄和产次）细节、受者手术（子宫切除术）结果和活产（日期和胎龄）。同行评议文献的检索显示，有 24 例已故供体子宫移植和 12 例活产（活产率为 66%），在随访期间有 25%的移植物丢失（24 例中有 6 例）。在这一系列中，有 12 例移植在美国进行（7 例活产），5 例在捷克共和国进行（1 例活产），3 例在意大利进行（1 例活产），2 例在土耳其进行（2 例活产），2 例在巴西进行（1 例活产）。受者的中位年龄为 29.8 岁（范围 21-36 岁），供者的中位年龄为 36.1 岁（范围 20-57 岁）。24 名受者中，100%患有 MRKH（Mayer-Rokitanski-Kuster-Hauser）综合征。两名活产来自未生育的供体。已故供体子宫移植的活产率与文献中报告的活体供体活产率非常相似，但在第一组中，伦理问题可能不那么重要。有必要在国际子宫移植登记处登记每一个病例，以便进行系统评价，并与活体供体的活产率进行比较。
