Those who suffer from infertility, either due to a congenital or acquired cause and cannot or are opposed to other means, such as surrogacy or adoption, to have a child, are potential candidates for uterine transplantation. Uterine transplantation is a form of allograft transplantation, meaning that it is a transplant of tissue from a donor who is genetically different from the recipient. Additionally, it is a vascularized transplant, including donor blood vessels that will be sutured to the vasculature of the recipient (Testa et al. 2017). This procedure has been attempted around the globe with varying levels of success ranging from delivery of a healthy child to necrosis of the graft and rejection of the transplanted tissue. While there does not seem to be one specific reason that can account for the rejection of a uterus transplant, the main factor responsible for failure is problems with arterial inflow or venous outflow in the recipient. Other potential factors that may contribute include cervix-vaginal size differences between donor uterus and recipient, pathology of the donated uterus, immunosuppressants, and wait time from transplant to embryo transfer. Advancements in robotic assisted hysterectomy to procure the donor uterus, using ovarian veins instead of uterine veins for venous outflow, and deceased donor uteri instead of living donor uteri are all promising ways that can streamline the transplant process and help transition the experimental procedure of uterine transplantation to an accepted clinical one.
Stern, R. (2020). Uterine Transplantation: A Review of Some of the Factors that Account for the Success or Failure of this Experimental Procedure. The Science Journal of the Lander College of Arts and Sciences, 14(1), 52-58. Retrieved from https://touroscholar.touro.edu/sjlcas/vol14/iss1/6