The XX Factor

Surgeons Performed Four Living-Donor Uterus Transplants, a First for the U.S.

Doctors at Baylor University Medical Center performed the transplants, three of which have had to be reversed.

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Four women received transplanted uteruses from living donors at Baylor University Medical Center in Dallas last month. Time reports that doctors performed the first-in-the-nation surgeries between Sept. 14 and 22. Three of the uteruses have since been removed after failing to achieve proper blood flow; the fourth patient’s transplant seems to be holding up well so far.

Several successful uterus transplants have taken place in Sweden, where five out of the country’s nine recipients have had healthy babies incubated in donor wombs. Only two of those uteruses were removed because of infection or clogged arteries. The first baby to be born from a transplanted uterus was born in 2014 to a 36-year-old mother who received a donated uterus from a post-menopausal friend. Two Swedish surgeons who’d transplanted uteruses before participated in the September surgeries at Baylor.

The only previous uterus transplant performed in the U.S. ended in disappointment in March. The late-February surgery at the Cleveland Clinic used a uterus from a deceased donor; about a week later, doctors found that it was compromised by a serious fungal yeast infection and removed it from the 26-year-old patient. At this stage in the trial period for the procedure, once a transplanted uterus is removed from a patient, doctors won’t try again on that patient. If a transplant holds, doctors will create an embryo through in vitro fertilization and implant it into the uterus. After the patient has attempted to get pregnant just one or two times, surgeons will remove the uterus to help safeguard the health of the patient, who will have to stay on immune function–suppressing anti-rejection drugs for as long as the donor uterus remains in her body.

Like the Cleveland patient, Lindsey McFarland, the first four Baylor recipients were born without uteruses as a result of Mayer-Rokitansky-Küster-Hauser syndrome, a congenital condition that affects about 1 in 4,500 women. The living donors who gave their uteruses to the Baylor patients are “altruistic” donors—anonymous donors who aren’t family members or friends. The donors are aged 35 to 60, and the recipients are between 20 and 35.

Giuliano Testa, the lead surgeon for the Baylor transplants, told Time that about 50 women stepped forward as potential anonymous uterus donors. “I am totally amazed by that,” he said. “They told us, ‘We had our chance to become mothers, and now we have this uterus and it’s not doing anything for us. We can put this uterus to use for people who really need it.’ ” The medical center plans to complete six more uterus transplants before the end of the year.