Healthcare

Organ transplants — a sign of empathy and care

Imagine being able to conceive and birth a child despite infertility, or having been born without a womb or losing one to cancer. Thanks to the miracle of modern science, that hope is now a reality, not only via a transplanted live womb (11 previous births have used wombs from a living donor) but, for the first time ever, successfully from a cadaver.

What makes this event in Brazil so incredible (the baby girl was born by C-section on Dec. 15, 2017), beyond the sheer emotions of life-affirming joy at a new life, is the complex and intricate science involved. Science made more difficult by the compromised rich uterine blood supply in a deceased donor.

Science of the intricate ten-hour operation to connect blood vessels, muscles, ligaments, muscles and nerves of the vagina with the donated uterus. Science overcoming the needed immunosuppressives post-operatively to make it through a pregnancy and delivery without complications. Science enabling a new life to be born into the world.

The first uterine transplant from a live donor took place in 2002, but the first successful transplants where the organ remained viable were completed in 2011-12. 

Swedish doctor Mats Brannstrom pioneered the procedure. There was a successful nine-case series; seven of the nine remained viable. Since that time, two babies have been born from transplanted live donor's at Baylor in Texas and an additional baby born in Serbia.

When it comes to using deceased donors, doctors at the Cleveland Clinic attempted this in 2016 but were unsuccessful, due to infection. Other previous failed attempts have taken place in Turkey, the Czech Republic and the U.S.

The report of the successful case of transplant and birth in Brazil was published this past week in the esteemed journal Lancet. Two more transplants are now planned.

The mother is a 32-year-old psychologist. She was suffering from Mayer-Rokitansky-Kuster-Hauser syndrome, a rare genetic condition in which a patient's vagina and uterus are either absent or underdeveloped. The donor was a 45-year-old woman who previously had three children but died following a stroke.

The uterus was kept on ice for eight hours between the time it was removed and implanted, a long amount of time which demonstrates just how amazing and resilient an organ the womb is. The patient underwent in vitro fertilization to produce viable embryos months before the operation, which were then cryopreserved and implanted several months after she received the new uterus.

After the successful birth, the mother's treating doctors removed the transplanted uterus, partly so she would no longer have to continue taking anti-rejection drugs. The womb had done its job and delivered a healthy baby.

This scientific advance is huge in terms of opening doors for women and families who had given up on the idea of having children because of diseased or malformed organs. The successful transplant and birth adds to the list of reasons to offer your own organs for transplants in case of a catastrophe. Think of it: The unfortunate 45-year-old woman who died not only helped a 32-year-old woman become pregnant but also helped new life come into this world.

Organ transplant is a beautiful gift and an important recognition of a person's responsibility and empathy for others.

In the case of the transplanted uterus in Brazil, a new baby girl has two women to thank - her mother and the woman who selflessly donated her womb to science and life.

Marc Siegel M.D. is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent.

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