Temple doctor comments on uterus transplant possibility
When the news emerged in January of a New York hospital moving toward the first potential uterus transplant in the United States, the hopes of women unable to bear children rose quickly. But questions remain about the safety and efficacy of the procedure, and some critics have called for more research before performing the transplant on women.
Current organ donor networks do appear able to supply uteri for transplantation, according to findings after a six-month study by researchers from New York Downtown Hospital, published recently January 2007 in the journal Obstetrics and Gynecology. The uteri could come from deceased donors similar to other organ transplants, and women whose uteri have been removed or who are not able to have children would be candidates for the procedure.
After the birth, doctors would remove the uterus so the woman would not need anti-rejection drugs her whole life.
Image courtesy Temple Health System
“I’m hopeful that uterus transplantation could be possible. It could be a tremendous opportunity. It’s more than a quality-of-life issue for women unable to carry a pregnancy, said Dr. Vincent Armenti, at Temple University in Philadelphia, who keeps a registry tracking pregnancies throughout North America in which the mother or father has been a transplant recipient.
He has found that although there is not a documented increase in birth defects associated with the use of anti-rejection medications during pregnancy,certain drugs may need to be avoided or adjusted.
For instance, some newer anti-rejection drugs require more evaluation, explained Armenti, a professor of surgery and acting surgical director of the Abdominal Organ Transplant Program at Temple University's School of Medicine, and a physician at Temple University Hospital.
Since its inception in 1991, his registry has recorded 1,547 pregnancies in 990 transplant recipients — including liver, pancreas and kidney, heart and lung recipients — and as of January 2006, birth results have not differed much from the general population. For example, of 772 pregnancies in kidney recipients, 590 births resulted with the rest resulting in miscarriages or an abortion by choice.
Through the registry, Armenti can track patterns and trends such as the advances in anti-rejection medications and how they affect pregnancies in different organ transplant recipients. In turn, this helps Armenti and other physicians advise recipients who want to have children.
“Successful pregnancies are possible in all solid organ recipients. It doesn’t mean it’s for everyone though,” Armenti said. “Pregnancy outcomes are best if there is stable transplant function.”
Next year, plans are in place to commemorate the 50th birthday of the first recorded birth from a transplant recipient. The first transplant — a kidney transplant — took place between two identical twin brothers in 1954.
“Fifty years ago, who would have imagined pregnancy after transplantation?” Armenti said. “This just shows us where our technology, medications and initiative can take us.”
- Anna Nguyen
Dr. Vincent Armenti, principal investigator of the National Transplantation Pregnancy Registry (NTPR) based at Temple University, was recently featured in a national Associated Press article about the potential for the first uterus transplant in the United States by New York Downtown Hospital. He commented on the use of anti-rejection drugs during pregnancy based on data from the registry.
To contact the NTPR: