India's first donor uterine transplant successfully performed in Pune.

Courtesy:Indianexpress.com

With its first uterine transplant performed uneventfully in the city of Pune on Thursday, India joins the list of handfuls of countries around the world with successful uterine transplant surgeries.

A team of 12 doctors from Galaxy Care Laparoscopy Institute Pune carried out this feat after 9 hours of surgery, led by oncosurgeon Dr Shailesh Puntambekar.

“The surgery has been a success. The next 48 hours will be crucial and the patient will be under observation,” said Dr Puntambeker. 

"The procedure is difficult because multiple large arteries are to be joined there, and veins that are small and short. It is technically very tough." He further added.   

It was a donor transplant; the uterus being donated by mother to her daughter who had Müllerian agenesis. The organ was retrieved by laparoscopic surgery, while it was transplanted by open surgery.

The selection Criteria’s for donor and recipient of uterus transplant can be accessed here.  

The donor is doing well and the recipient will need a close watch in ICU for about a week. The immediate success of the surgery can only be assessed by doppler sonography which will determine successful vascularization of the transplanted organ.

Whether the transplant would be successful in terms of pregnancy and birth remains to be seen and it’s a long wait before success is seen on these fronts.  

Transplant research, as a whole, has also tended to focus on life-saving transplantation (heart, kidney, liver) with womb transplant research being rather limited especially following advances in IVF techniques.

Uterine Transplants are Unique in the sense that unlike any other transplants, they are ‘ephemeral,'” Cleveland Clinic lead researcher Andreas Tzakis said in the release. “They are not intended to last for the duration of the recipient’s life.” 

After 1-2 healthy pregnancies, the transplanted uterus is either removed or allowed to disintegrate.

In 2000, the world’s first womb transplant was performed on a 26-year-old woman in Saudi Arabia. But, the transplanted womb only lasted for 99 days.

In September 2014, Mats Brännström and colleagues report the first successful birth of a child following uterus transplantation. The recipient, a 35-year-old woman lacking a uterus (Rokitansky syndrome), received a cryopreserved embryo 1 year after transplantation, leading to a live-birth by cesarean section.

The donated uterus came from the woman’s own mother, so the baby is also the first born to a woman using the same womb from which she emerged herself.

This team has since performed a total of nine uterus transplants that have resulted in five pregnancies and four live births.

The first cadaveric uterine transplant in US was performed at Cleveland clinic in February, 2016 but it failed after 2 weeks because of a fungal infection.