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How Baylor Pulled Off The Uterus-Transplant Birth

Late last year, a woman gave birth to a baby via a transplanted uterus – the first time that’s ever happened in the U.S. The boy was born at Baylor University Medical Center in Dallas, and guest host Lauren Silverman talks about how the procedure was pulled off with members of the team who performed it: Dr. Liza Johannesson, an ob-gyn and uterus transplant surgeon at Baylor; and Dr. Giuliano Testa, the leader of the hospital’s uterus transplant clinical trial.

Interview Highlights

On women born without a uterus

Most of the patients in Baylor’s trial had Mayer-Rokitansky-Küster-Hauser syndrome, Johannesson says. That means a woman is born without a uterus, but she has her own ovaries. Otherwise, she’s completely normal. The syndrome affects about one in 4,500 women, Johannesson says.

A woman can have other uterine issues that contribute to infertility, such as malfunctions in the uterus, a malformed uterus, certain cancers and bleeding during childbirth. These problems affect about one in 500 women, Johannesson says.

In the U.S., about 80,000 women of reproductive age are affected by such complications, she says.

About the breakthrough donor

The donor who gave her uterus that led to the successful birth at Baylor was a nurse with two kids, Testa says. She wanted to help the woman bear her own child.

“She simply said, ‘I’ve had this chance in my life,’” Testa said.

The nurse was not related to the recipient in the trial, which surprised the medical team, Johannesson said. In her experience in Sweden, Johannesson says the living donors were related to recipients or at least knew them in some way.

“But [in the U.S.], all of a sudden, 100 women, almost, called in saying, ‘I want to give up my uterus to this unknown woman that I’m probably never going to meet just to give them a chance to be pregnant,’ and that was kind of amazing,” she said.

On acquiring resources for uterine transplants

Uterine transplants aren’t like heart transplants; they’re not critical for someone to live. Testa says that fact is what makes it difficult to secure resources — time and money — for continued exploration.

He knows it’s not a life-saving procedure, but it’s still part of advancing medical research.

“There’s something absolutely beautiful about the idea that you can restore normalcy in somebody that has no fault of their own for not having a uterus,” he said.

He says that’s his main reason to justify investing in the procedure. He says transplantation brings many ethical questions, especially when it comes to the cost.

Why the uterine transplant is unique

The uterine transplant is not a permanent transplant.

“It’s the only transplant ever made that you work so hard to make it work, and then when it has exhausted its function, you take it out,” Testa said.

You don’t want to keep the woman on the necessary medications for the rest of her life. And you don’t want to leave a transplanted uterus in her body that could be exposed to other diseases, like any other uterus.

Baylor’s trial allows for the transplanted uterus to carry two children, Testa said.