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Uterine transplant trials on horizon

The Yomiuri Shimbun

The Yomiuri ShimbunA Keio University medical team intends to apply to the university’s ethics panel this year to perform uterine transplants (see below) on women born without wombs, as a means to help such women conceive and give birth, according to sources.

If approved, it will be the first time uterine transplants are performed in Japan. There are a few cases of the procedure being performed overseas in which women successfully gave birth.

Uterine transplants are performed to help women without wombs give birth, in contrast to heart and liver transplants that are meant to sustain the lives of the recipients.

For this reason, the medical team plans to obtain approval for the clinical study from the ethics panel and relevant academic societies before carrying out uterine transplants over three years on five patients who suffer from the Rokitansky syndrome — a congenital condition which results in females being born without a womb — the sources said.

For the clinical study, wombs will be provided by the mothers of recipients or other female relatives.

In the future, women who have their wombs removed due to cervical cancer or other diseases could be eligible for such treatments.

In February 2016, the medical team set up a working panel comprising 13 clinical departments at the university, including obstetrics, gynecology and pediatrics. A variety of specialists, including doctors, nurses and transplant coordinators, have been holding discussions once a month on the technical challenges and post-delivery care, in preparation for what will potentially be the first uterine transplant in the country.

Concerning uterine transplants, experts point out some challenges — among others, whether it is acceptable to risk serious physical or psychological harm to donors to help recipients give birth, and whether administering immunosuppressants to recipients to prevent organ rejection could have adverse effects on the health of their babies.

Therefore, the medical team will submit its clinical study plan not only to the university’s ethics panel, but also to the Japan Society of Obstetrics and Gynecology and the Japan Society for Transplantation, asking them to assess whether the clinical study would involve any problems in terms of safety and ethics.

The first ever uterine transplant was conducted in Saudi Arabia in 2000, and a woman successfully gave birth to a baby after having the procedure in Sweden in September 2014 — a world first. It has been reported that at least five women delivered babies after uterine transplants in the country. There have been no reports that either donors, recipients or the children born as a result of the procedure died.

In 2013, Keio University announced that, partnered with the University of Tokyo and other organizations, they had successfully removed the womb from a female monkey, transplanted the organ back into its body and delivered a baby.

“Our clinical study is meant to provide an option for women born without wombs,” said Koji Banno, a full-time lecturer at Keio University and a member of the medical team. “We believe this kind of transplant is quite possible from a technical viewpoint, but it is necessary for a broad range of the public to discuss the pros and cons regarding these kinds of treatments.”

■ Uterine transplants

A procedure in which wombs are implanted in women who were born without the organ due to a congenital condition, or had it removed due to cancer and other diseases. Women who have the procedure can potentially give birth after having their in vitro fertilized eggs inserted into their new wombs. In Japan, an estimated 60,000 to 70,000 women in their 20s and 30s could benefit from the treatment. Middle-aged or older women can become donors because wombs maintain functions to help babies grow even after menopause.Speech

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