“We wanted to resoundingly prove that India could perform its first uterine transplant without being the handmaid of Sweden,” said an elated Dr. Shailesh Puntambekar, medical director, Galaxy Care Laparoscopy Institute (GCLI), on the country’s first uterine transplant on a 21-year-old woman from Solapur in a day-long operation on Thursday.
The woman, who suffers from a congenital uterus absence, was fitted with her mother’s womb, which was retrieved through laparoscopic or minimally invasive surgery, said Dr. Puntambekar on Friday. “The retrieval of organ was done laparoscopically so as not to damage blood vessels. It was only towards the end, while removing the organ from the donor’s body, did we make a small incision.”
Cardiovascular thoracic surgeon Sanjeev Jadhav, who played a pivotal role in the operation, incidentally becomes the first surgeon to perform transplants of the heart, lung, kidney and uterus. Dr. Jadhav said both the donor and the recipient are stable. The donor is up and about while the recipient has been put on ventilator which is to be removed sometime on Friday. “Even a slight movement can shear blood vessels. Hence, to preclude risk, we have kept her on ventilator in the ICU,” said Dr. Puntambekar.
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The operation, Dr. Puntambekar said, was completed within the projected time of nine hours.
It took the team four-and-a-half hours to retrieve the uterus from the donor, which included an hour of prolonged anaesthesia, forty-five minutes when the donor’s uterus is kept ‘on table’ where the veins and arteries are flushed of blood and cooled to -18 degrees Celsius, and the remaining time when the team prepared the bed for the patient. The Doppler tests conducted on Friday morning showed that the blood was flowing normally to the newly transferred uterus. The recipient would remain in the ICU for a week and for another fortnight in general care. The surgery’s immunological success will be measured after a week when the receiver’s body does not reject the organ.
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“This was not a one-day event... we have been preparing this for over a year. In both cases, the donor and recipient are educated and are fully aware of the risks the surgery entails,” Dr. Puntambekar said. There are 21 persons on the wait-list to receive a uterine transplant, said Dr. Milind Telang, a gynaecologist who is part of the team.
Second transplant
The second transplant is scheduled to begin sometime after 2 p.m., said Dr. Jadhav. The case is that of a lady from Baroda with a dysfunctional uterus, suffering from Asherman’s Syndrome (adhesions or internal scar tissues) and who will receive her mother’s womb. After the experience of the first surgery, Dr. Puntambekar said the team was hopeful the second transplant would be accomplished in an shorter time. “We do not have to create a bed in the second case. In the first surgery, the recipient’s vagina was small and preparation of the bed took time.”