| Autor: |
Frisch EH; Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, OH 44195, USA., Falcone T; Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, OH 44195, USA., Flyckt RL; Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA., Tzakis AG; Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44195, USA., Kodish E; Pediatric Institute/Cleveland Clinic Children's and Cleveland Clinic Lerner College of Medicine, Cleveland, OH 44195, USA., Richards EG; Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, OH 44195, USA. |
| Abstrakt: |
Uterus transplantation is a surgical treatment for women with congenital or acquired uterine factor infertility. While uterus transplantation is a life-enhancing transplant that is commonly categorized as a vascular composite allograft (e.g., face or hand), it is similar to many solid organ transplants (e.g., kidney) in that both living donors (LDs) and deceased donors (DDs) can be utilized for organ procurement. While many endpoints appear to be similar for LD and DD transplants (including graft survival, time to menses, livebirth rates), there are key medical, technical, ethical, and logistical differences between these modalities. Primary considerations in favor of a LD model include thorough screening of donors, enhanced logistics, and greater donor availability. The primary consideration in favor of a DD model is the lack of physical or psychological harm to a living donor. Other important factors, that may not clearly favor one approach over the other, are important to include in discussions of LD vs. DD models. We favor a stepwise approach to uterus transplantation, one in which programs first begin with DD procurement before attempting LD procurement to maximize successful organ recovery and to minimize potential harms to a living donor. |
