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First-In-US Uterus Transplantation Fails Due To Post-Surgical Complications

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Uterus

A 26-year-old Texas woman – who was born without a uterus – was the recipient of the donor organ, and was participating in a clinical trial for the treatment of uterine factor infertility.

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March 14, 2016 | by Sarah Massey, M.Sc.

Hospital officials at the Cleveland Clinic reported that the first ever uterus transplant to take place in the US has failed, after the patient experienced sudden complications following surgery. A 26-year-old Texas woman – who was born without a uterus – was the recipient of the donor organ, and was participating in a clinical trial for the treatment of uterine factor infertility.

This type of infertility is linked to a number of issues affecting the uterus, including uterine fibroids, Adenomyosis, Asherman’s syndrome and congenital abnormalities. Uterine factor infertility often results in the inability to get pregnant, or carry a pregnancy to term.

Current estimates suggest that three to five percent of the world’s women have uterine factor infertility, and there are few treatments available for this condition. The transplant surgery – which took nine hours to perform – was just the first of ten total procedures planned for the clinical trial.

The doctors running the trial received approval to start the study from the Cleveland Clinic’s Institutional Review Board, in November of 2015. Up until last week – when the first patient had to have the donor organ removed – the doctors conducting the clinical trial believed that the procedure had been a success.

The statement released last Wednesday, revealed that patient experienced unexpected complications as a result of surgery. “At this time, the circumstance of the complication is under review and more information will be shared as it becomes available,” said hospital officials in the statement.



The patient – known only as Lindsey – also released a small statement following her experience. “I just wanted to take a moment to express my gratitude towards all of my doctors,” she said. “They acted very quickly to ensure my health and safety. Unfortunately I did lose the uterus to complications. However, I am doing okay and appreciate all of your prayers and good thoughts.”

According to the physicians at the Cleveland Clinic, there are always risks associated with organ transplantation, and sometimes these complications can necessitate removal of the organ. To further complicate matters, uterus transplantation is in some ways trickier than other types of organ transplant, because the organ must be connected to the patient’s blood vessels deep inside the pelvis.

While this type of surgery is still highly experimental, the procedure has been successful in other countries. A 36-year-old Swedish woman was the first to successfully give birth after receiving a transplanted uterus in 2014. Doctors in the UK have also carried out their own clinical trials of the surgical procedure.

While all uterus transplants conducted in Sweden have used live donors, the operation performed on Lindsay used a deceased woman as its donor. At the moment, however, the doctors do not believe that this decision caused the complication, as using living donors presents its own set of challenges.

Doctors at the Cleveland Clinic are reportedly going ahead with the rest of the clinical trial, despite the disappointing outcome of the initial surgery. “The exciting work from the investigators in Sweden demonstrated that uterine transplantation can result in the successful delivery of healthy infants,” said Dr. Andreas Tzakis, the physician leading the study at the Transplantation Center at Cleveland Clinic.


Keywords: Clinical Trial, Organ Transplant, Fertility


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