• Giuliano Testa, Greg J McKenna, Johanna Bayer, Anji Wall, Hoylan Fernandez, Eric Martinez, Amar Gupta, Richard Ruiz, Nicholas Onaca, Robert T Gunby, Anthony R Gregg, Michael Olausson, E Colin Koon, and Liza Johannesson.
• Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, Texas.
• Ann. Surg. 2020 Sep 1; 272 (3): 411-417.

ObjectiveWe report the results of the first 20 uterus transplants performed in our institution.Summary Background DataUterus transplantation (UTx) aims at giving women affected by absolute uterine-factor infertility the possibility of carrying their own pregnancy. UTx has evolved from experimental to an established surgical procedure.MethodsThe Dallas Uterus Transplant Study (DUETS) program started in 2016. The uterus was transplanted in orthotopic position with vascular anastomoses to the external iliac vessels and removed when 1 or 2 live births were achieved. Immunosuppression lasted only for the duration of the uterus graft.ResultsTwenty women, median age 29.7 years, enrolled in the study, with 10 in phase 1 and 10 in phase 2. All but 2 recipients had a congenital absence of the uterus. Eighteen recipients received uteri from living donors and 2 from deceased donors. In phase 1, 50% of recipients had a technically successful uterus transplant, compared to 90% in phase 2. Four recipients with a technical success in phase 1 have delivered 1 or 2 babies, and the fifth recipient with a technical success is >30 weeks pregnant. In phase 2, 2 recipients have delivered healthy babies and 5 are pregnant.ConclusionsUTx is a unique type of transplant; whose only true success is a healthy child birth. Based on results presented here, involving refinement of the surgical technique and donor selection process, UTx is now an established solution for absolute uterine-factor infertility.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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