First Ever Live Birth After Live-donor Uterus Transplantation in Gothenburg, and Six More Chances Awaiting

 So, perhaps some of you remember reporting and commenting somewhat a few years back (here and here) on the Gothenburg Live-donor Uterus Transplant Project at the Sahlgrenska University Hospital and Sahlgrenska Academy at my university, lead by Mats Brännström, and since then successful transplant-procedures have been reported (here and here), to be followed by attempts to establish pregnancies. Late yesterday night, the embargo was lifted on the Lancet article reporting the first live birth within this project, which is also the first such case ever. The child and the mother are reported to do well, albeit the article reports a few minor complications – in no way exceptional and dealt with in a routine manner. Six more pregnancies are reported to be under way in the project. Besides the article and general presentation video linked to above, here is a video telling the story of these recent events:

As Mats Brännström states in this documentation, the eventuality of uterus transplantation becoming a routine procedure for the small – though not insignificant – group of women for whom the procedure may be indicated lies far off into the future. The procedure is still highly experimental and requires outstanding skill and organisation (and has, in the Gothenburg case, been funded exclusively by research grants from private foundations). You may, of course, debate whether or not it should ever become more than that, if nothing else for reasons of priority, but this will depend on what the cost of a fully developed procedure would be, and, of course, how one values the outcome.

In the meantime, I want to condone Masts Brännström and his team, not least, for the example-setting openness and conscientiousness about the ethical ramifications of this project which has surrounded it from day one (this is one publication concentrating on this particular aspect). And, of course, I extend my congratulations for this success to the team and, not least, the patient.

More on the Ethics of Uterus Transplantation

Here are two posts that continues to ad takes on the recent news of advanced plans to conduct uterus transplantation at the Sahlgrenska University Hospital in my town.

one at the Oxford Practical Ethics blog by Charles Foster that generated a bit of a discussion (with myself as one of several participants), and

another, very fresh, at the Journal of Medical Ethics blog by Iain Brassington.

In short, Foster takes the discussion to a meta-level, while Brassington wriggles it back to the floor of the clinic.

Enjoy!

Uterus Transplantation: Clinical Trial Planned in One Year from Now

In October last year, I reported about the plans of a Swedish team of medical researchers, based in my city, to conduct uterus transplantation. At the time, they had just initiated the final stage of animal experiments on large primates, to validate safety and effectiveness of the procedure.

Today, BBC aired an interview with a woman who has agreed to donate her uterus to her own daughter, who suffers from the Mayer Rokitansky Kuster Hauser syndrome (MRKH) – one of the conditions targeted by this new procedure. The news is also presented in The Telegraph, and in Swedish media (here, here). The trial is planned to take place about one year from now at the Sahlgrenska University Hospital in Gothenburg (my home town).

I am unsure about how far the primate trials have proceeded, but before any trial is initiated, the responsible surgeon – Mats Brännström – will, by Swedish law, have to secure ethical permission. There are several potential risk factors with the actual surgery (as acknowledged by Brännström), and also uncertainty as to how the chances of establishing a pregnancy may be affected by the various parts of the procedure, such as drugs taken to prevent the new uterus to be attacked by the recipient's immune system. Presumably, the fact that the donor is a close relative of the recipient is a part of the actions taken to reduce this last risk factor (since less of the drugs will be needed than if the donor had been genetically more distant from the recipient).

My own guess is that the team will have to present very strong evidence to the Ethics Review Board, since the procedure is not life-saving. For other ethical considerations, see my earlier post!