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Saudi
Surgeons Carry Out World's First Womb Transplant
PARIS,
March 8 (News Agencies) - Surgeons in Saudi Arabia reported Thursday they had
carried out the first transplant of a human uterus, implanting the organ in a
26-year-old woman, Agence France-Presse (AFP) reported.
The
operation two years ago went well and there was no tissue rejection, but the
uterus had to be removed after a little more than three months because of sudden
clotting in the vessels supplying blood to it.
Despite
this setback, they said, the outcome holds out hope for transplanting uteruses
in young women who have had a hysterectomy or suffer from forms of infertility.
The
pioneering surgery was performed in April 2000 by a team led by Wafa Fageeh of
the King Fahd Hospital and Research Center in Jeddah. They reported their work
in a specialist publication, the International Journal of Gynecology and
Obstetrics.
The
recipient was a woman who had suffered severe bleeding after a caesarian section
at the age of 20 and had had her womb removed. The donor was a 46-year-old woman
with ovarian cysts who had been advised to have a hysterectomy.
After
the operation, the recipient was given drugs to discourage rejection by the
immune system. There was a brief episode of rejection on the ninth day, but this
was successfully countered.
The
woman was then administered with oestrogen and progesterone hormones that
kick-started the uterus into developing a normal lining and menstruating.
But
99 days after the transplant, blood supply to the uterus stopped because of
severe clotting in the uterine arteries and veins, and the organ was removed.
Tissue
analysis suggested that the new uterus had not been properly supported in the
body, and this had probably caused the linked-up blood vessels to become kinked
or twisted.
The
doctors said they were optimistic about the future for uterine transplants.
"Further
clinical experience and additional development of the surgical techniques could
make [possible] uterine transplantation in the treatment of infertility,
especially in communities where the surrogate-mother concept is unacceptable
from a religious or ethical point of view," they said.
In
an editorial, the Chicago-based journal said that the operation had had a
promising outcome.
The
clotting "is not the equivalent of a clinical failure," as the uterus
had already shown it could respond to the hormone treatment, it argued.
A
dissenting voice was offered by David Barlow, director of the assisted
reproduction unit at the John Radcliffe Hospital in Oxford, Britain, who said
blood connections "are major hurdles to overcome."
"The
uterus is a very dynamic and complex organ, and it is hugely blood-flow
dependent," he told the website of New Scientist, the weekly British
scientific journal.
"It
is supplied by four blood vessels, which are very small by transplant standards,
giving more scope for blood clotting."
Vessels
connected to a transplanted uterus would have to cope with a massive increase in
blood flow during pregnancy, he added.
The
surgeons carried out 18 trial transplants on animals before embarking on the
ground-breaking operation on a human. These animals comprised 16 baboons and two
goats.
Fageeh's
team said that the Islamic perspective on uterus transplants had been clarified
in March 1990, when a supreme authority, the Islamic Jurisprudence Council,
approved the transplant of reproductive organs that do not entail the transfer
of that organ's genes into successive generations.
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