India’s first uterine transplant performed

Pune doctors conduct the highly complex procedure on woman from Solapur

May 18, 2017 10:28 pm | Updated May 19, 2017 12:25 am IST - Pune

The surgery, by a team of 12 doctors, took more than 12 hours.

The surgery, by a team of 12 doctors, took more than 12 hours.

A team of 12 doctors at the city’s Galaxy Care Laparoscopy Institute (GCLI) successfully completed the highly complex and delicate procedure of India’s first uterine transplant on a woman from Solapur district on Thursday.

The woman suffers from congenital absence of uterus and is to be fitted with her mother’s womb to enable her to conceive normally.

The operation, in which the uterus was retrieved from the donor and transplanted into the recipient around 9 a.m., stretched well beyond its projected eight-hour duration exceeding 12 hours in time. The surgeons are retrieving the uterus using a laparoscopic technique. According to team members, the surgery was successful. While the donor’s health is fine, the recipient has been placed under a 24-hour observation, said Dr. Sanjeev Jadhav, one of the members of the team.

Dr. Shailesh Puntambekar, Medical Director, GCLI, who headed the surgery, was not available for comment.

Earlier, Dr. Puntambekar said the recipient would remain in the ICU for a week and for another fortnight in the general care following the surgery.

“During this period, the transplanted uterus will be studied,” he said. The immediate success of the surgery could then be assessed after sonography studies which would determine whether the uterus was getting regular blood flow and functioning normally.

The hospital, which has been granted a licence by the State Directorate of Health Services to carry out the uterus transplant, is scheduled to conduct another womb transplant on Friday on a 24-year-old woman from Baroda who suffers from Asherman’s Syndrome (scar tissue in the uterus) and who will receive her mother’s womb.

Still in its nascent, experimental stage, only a handful of these operations have met with success in other countries, primarily in Sweden.

The operations are meant to help women who want to conceive but cannot because they were born without uterus, suffered damage to it or had to have it removed.

Organ rejection

However, the 20-odd uterine transplant operations round the world have often been frustrated by organ rejection (in which the patient’s immune system attacks the organ; an infection of the organ; or problems with the organ’s blood supply.)

In 2012, doctors at the University of Gothenburg in Sweden led by Dr. Mats Brännström performed nine uterus transplants, resulting in five births. Two of the nine transplants failed during the first year after the surgery and had to be removed.

The first baby, born to the recipient in 2014, was delivered prematurely through Caesarean section, and was healthy.

If the surgery is successful, both the recipients will be able to conceive using in-vitro fertilisation (IVF) and have children. Both donor and recipients undergo screening procedure post which the uterus is retrieved and transplanted in the recipient, who undergoes three surgeries.

The first uterine transplant in the U.S., which was performed in February last year on a 26-year-old woman from Texas, Lindsey MacFarland, at a Cleveland clinic in Ohio, failed despite the efforts of a team of highly experienced doctors who had practised on animals and cadavers.

It was the first of 10 uterine transplants planned by the clinic, in an experimental programme meant to enable women without uterus to become pregnant and give birth.

In April 2000, a woman who received uterus transplant in Saudi Arabia (considered to be the world’s first uterus transplant) needed the organ removed barely three months after the operation. In that case, the organ deteriorated after clots blocked the blood supply.

Another woman in Turkey received uterus transplant from a deceased donor in 2011, and while she was able to conceive, she unfortunately miscarried.

In the Swedish trials, the uterus came from a live donor unlike the U.S., where the donor was deceased.

Some experts have expressed concern about the operations, terming them an invasive surgical procedure fraught with risks.

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