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| 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.
