India: Pune Surgeons Perform Second Uterus Transplant

Within 48 hours of the first uterus transplant in Pune, India, a second uterine transplant has been performed by the same team. The second recipient of a uterus, a 24 -year-old woman from Baroda, is said to be comfortable and that the operation went well.

The uterine transplant operation performed Friday at the Galaxy Care Hospital in Pune, southwest India, was the first of its kind in the country. The 21-year-old recipient was born without a womb and the donor, her 45 year-old-mother, is hopeful that her daughter will one-day experience childbirth. The operation was led by Dr. Shailesh Puntambekar, the hospital’s medical director. Speaking to CNN, Dr. Puntambeker described the complexity of the procedure.

The procedure is difficult because multiple large arteries are to be joined there, and veins that are small and short. It is technically very tough

The initial operation lasted for approximately nine hours, and retrieval of the donated uterus was performed mainly through key-hole surgery, the medical term for which is laparoscopic surgery. Open surgery, however, was performed to transplant the uterus to its recipient. Dr. Puntambeker went on to describe the methods employed to perform the surgery as groundbreaking.

This is the first time in the world that both transplants were done via minimal access laparoscopic surgery,

The second transplant patient suffers from a condition known as Asherman’s syndrome, a scarred uterus, and after carrying two babies to term lost them both to miscarriage. As a result of the trauma of the miscarriages, the patient’s uterus has been non-functional for almost three years. Both transplant patients will have to wait a month before surgeons can ascertain whether the newly transplanted uterus will be accepted or rejected by their bodies.

Only six babies have ever been delivered from a uterine transplant, two of which were born to the same mother. Although several countries have attempted the procedure, including the U.S., Saudi-Arabia, Germany and Turkey, the only successful outcomes came from a Swedish team of specialists from the University of Gothenburg.

There is a twelve month waiting period before the recipients of a transplant can have their wombs implanted with fertilized eggs by the invitro-fertilization method (IVF). The patient’s eggs are harvested before the transplant operation and are then fertilized with their partner’s sperm and later frozen. The recipient of a uterine transplant cannot conceive through intercourse.

Sweden’s first mother-to-daughter uterus transplants, led by Mats Brännström, were performed on two women aged 32 and 37-years-old, in 2012. One of the women had to undergo a hysterectomy due to cancer, and the other woman was born without a womb. In both instances, the recipient’s mother’s were chosen as donors because of the required tissue match, and both of the women had demonstrated that their wombs were capable of carrying a foetus to term. Nonetheless, the recipients were only permitted two pregnancies before having the transplanted uteri removed.

Mayer-Rokitansky-Küster-Hauser syndrome, or being born without a womb, affects approximately one in 5,000 women who, subsequently, would be unable to bear children without a transplant. Globally, it is estimated that almost two million women are affected by uterine infertility.

The very first uterus transplant was performed in 1931 in Germany. Sadly, however, the recipient of the uterus, a transgendered woman by the name of Lile Elbe, died three months following the transplant when her body rejected the organ. In 2011, a Turkish team of surgeons from Akdeniz University performed a uterine transplant from a deceased donor. Although the recipient, a 21-year-old woman named Derya Sert, became pregnant within two years of the surgery, it was later announced that the pregnancy had been terminated when doctors were unable to detect a fetal heartbeat.

Since the first uterus transplant in India, more than 20 women have registered for a transplant at the Galaxy Hospital in Pune. Nonetheless, as the surgery is not risk-free and the number of pregnancies which will result from the procedure is unknown, commentators have called upon the medical profession to offer women alternative options, such as adoption or surrogacy.

[Featured Image by Sean Gallup/Getty Images]