Living Donor Uterus Transplantation: A Single Center's Observations and Lessons Learned From Early Setbacks to Technical Success

Am J Transplant. 2017 Nov;17(11):2901-2910. doi: 10.1111/ajt.14326. Epub 2017 May 23.


Uterus transplantation is a vascularized composite allograft transplantation. It allows women who do not have a uterus to become pregnant and deliver a baby. In this paper, we analyze the first five cases of living donor uterus transplantation performed in the United States. The first three recipients lost their uterus grafts at days 14, 12, and 6, respectively, after transplant. Vascular complications, related to both inflow and outflow problems, were identified as the primary reason for the graft losses. Two recipients, at 6 and 3 mo, respectively, after transplant, have functioning grafts with regular menstrual cycles. Ultimate success will be claimed only after a live birth. This paper is an in-depth analysis of evaluation, surgical technique, and follow-up of these five living donor uterus transplants. The lessons learned were instrumental in allowing us to evolve from failure to technical and functional success. We aim to share our conclusions and build on knowledge in the evolving field of uterus transplantation.

Keywords: clinical research/practice; donors and donation: living; surgical technique; vascularized composite and reconstructive transplantation.

Publication types

  • Clinical Trial
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Graft Rejection / epidemiology*
  • Graft Survival
  • Humans
  • Infertility, Female / therapy*
  • Living Donors*
  • Middle Aged
  • Postoperative Complications*
  • Pregnancy
  • Pregnancy Outcome
  • Risk Factors
  • Uterus / transplantation*
  • Young Adult