Successful womb transplant between sisters is a first for Spain

THE FIRST-EVER successful womb transplant from a live donor has been carried out in Spain, and two months later, the recipient appears to be fertile.

Barcelona's Hospital Clínic says the patient is one of around 5,000 women in the world with the congenital disorder known as Rokitansky's Syndrome, meaning she was born without a womb or fallopian tubes.

She was one of 30 candidates for a uterine transplant at the Hospital Clínic, and turned out to be the only one compatible.

The womb was donated by her sister, who underwent a 12-hour operation for the organ to be extracted – much longer than a standard hysterectomy, since the uterus had to be in a perfect condition when it was removed.

It took another four hours to implant it in the receptor – the work of a 20-strong team who included nurses, auxiliaries, gynaecologists and transplant surgeons.

Team leader Dr Antonio Alcaraz explains that the uterus is a 'very complex organ', with 'extremely poor vascularisation in the arteries' and 'a tangled web of veins', meaning to transplant it, they had to 'seek out the largest veins to drain the blood which would feed the womb'.

They used a robotic method of extraction so that, even though it took 12 hours, the operation was, for the donor sister, as minimally-invasive as possible.

The recipient was given the corresponding medication to induce menstruation, after which the treatment process can begin for implanting a pre-frozen embryo.

A total of 11 eggs were successfully fertilised and have become embryos, and the best-quality one will be chosen for implant.

If she becomes pregnant through the implantation process, and carries the baby to term, she will be given the option of having a second child via the same method. 

Any viable embryos left over once she has had the number of children she wants can be donated to other women, anonymously, as long as the eggs came from a woman aged under 35.

The patient will have to continue to take immune-suppressant drugs throughout her pregnancies, which were prescribed to her from the moment of the transplant operation to prevent her body's rejecting the organ.

Once she has had two children, if she decides not to have any more, the patient's donor womb will be removed by laparoscopy if she wishes, meaning she will no longer have to take immune-suppressant medication.

Surgery was completed on October 5, but details have only just been released, since it was a 'waiting game' to see whether she began menstruating; if she did not, it would mean the transplant had failed.

Hospital Clínic has just revealed that, two months after the operation, the patient has had her first period – the first in her life, in fact, given her medical condition – meaning the medication process and embryo-implanting can begin.

If all goes according to plan, she could be pregnant by Christmas.

Although this is the first womb transplant performed in Spain, it is not the first in Europe: Back in 2014, Dr Mats Brännström of Salhgrenska University Hospital in Gothenburg, Sweden, reported that the world's first baby had been born in a donor uterus.

To date, 70 womb transplants have been carried out worldwide, leading to around 20 babies having been born so far.