Swedes Perform Pioneering Uterine Transplants; Americans Not Far Behind

A surgical team with Sahlgrenska University Hospital in Gothenburg, Sweden, performs the first mother-to-daughter uterine transplant.

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STEVE INSKEEP, HOST: Doctors in Sweden have begun writing another chapter in the story of human organ transplants. They've taken uteruses from two women in their 50s, and transplanted them into their daughters. One of the younger women had previously lost her uterus to cancer, while the other was born without one. NPR's Richard Knox says the doctors are confident the daughters will be able to bear children.

RICHARD KNOX, BYLINE: Transplant surgeon Michael Olausson says the idea was born a dozen years ago, when his colleague Mats Brannstrom had to do a hysterectomy on a young woman with cervical cancer.

DR. MICHAEL OLAUSSON: And she asked, why can't you just transplant the uterus? You can transplant other organs, why isn't it possible to do that? That got him started in the research project.

KNOX: Olausson, speaking on a cellphone, says the team transplanted uteruses in many different animals.

OLAUSSON: Mice, rats, sheep, pigs and primates.

KNOX: The transplanted animals were able to have normal pregnancies and healthy offspring. So last weekend, the team moved into humans. The patients haven't been identified, but Olausson says the mothers were happy to participate.

OLAUSSON: They're done with their baby-making, and so they have decided to donate their uterus to the daughters.

KNOX: One of the mothers was past menopause.

OLAUSSON: It does not really matter if they are menopausal - or not - because the uterus can be sort of refurbished with hormones. So that's not a problem, in itself.

KNOX: That's remarkable - but not as amazing as the possibility these women may be able have a baby. To do that, the transplanted wombs will have to withstand the stresses and strains of pregnancy. No other organ has to undergo such enormous changes. But Olausson confidently predicts success on the basis of animal experiments. So far, the patients are recovering nicely.

OLAUSSON: They're doing fine - both the donors and the recipients. All four of them are doing fine.

KNOX: But the real test will come late next year, and in 2014. That's when doctors will put previously frozen embryos from these women into the transplanted uteruses, and cross their fingers that all goes well.

DR. MICHAEL GREEN: Don't get too excited quite yet; too soon to make a judgment.

KNOX: That's Dr. Michael Green of Massachusetts General Hospital. Green says no one knows whether these women will avoid the many perils of pregnancy. They'll have to take anti-rejection drugs, which may pose a hazard. But he raises a broader question: Is this kind of transplant really necessary? When doctors began transplanting nearly six decades ago, they started with organs essential for life - kidneys, hearts and livers. Lately, they've been doing what Green calls optional transplants.

GREEN: Nobody needs a uterus to live, OK? Nobody needs a hand or a face to live, in fairness. It's a quality-of-life issue. This is in that same category. So we've opened the door; we've stepped through it. And this is one of the next, logical things that people might do.

KNOX: Now, if a woman who lacks a uterus wants a baby, she can turn to a surrogate mother - if she can afford it. Green wonders if health-care dollars should be spent on uterine transplants. But Dr. James Grifo hopes the Swedish experiment succeeds. He's a fertility expert at New York University who's done his own research on uterine transplants, but abandoned that work to pursue other priorities. Grifo sympathizes with women who might want a uterine transplant.

DR. JAMES GRIFO: I don't think it's a simple discussion, by any stretch. You know, when you're the patient, then you fully understand the issues. When you're just theoretically discussing these things, unless it actually hits home, I think you don't really, fully understand it.

KNOX: The Swedes plan to do 10 more uterine transplants. The next two could be sometime this fall.

Richard Knox, NPR News.

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