| 1. |
- Brännström, Mats, 1958, et al.
(författare)
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Fixation of the uterine graft after uterus transplantation
- 2020
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Ingår i: Uterus Transplantation. Brännström M. (red.). - Cham : Springer. - 9783319941622 ; , s. 147-149
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- At uterus transplantation into the recipient, surgical fixation of the uterus is important and performed after anastomoses of the vasculature and the vagina which has been done in order to minimize warm ischemia and secure optimal location of the uterus with its vessels. At the stage of fixation, the uterine graft is reperfused. The fixation of the uterus is recommended onto several ligamentous structures in order to prevent prolapse of the organ in the pregnant and non-pregnant state. © Springer Nature Switzerland AG 2020.
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| 2. |
- Brännström, Mats, 1958, et al.
(författare)
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Medical work-up of the live donor
- 2020
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Ingår i: Uterus Transplantation. Brännström M. (red.). - Cham : Springer. - 9783319941622 ; , s. 83-87
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- The accumulated experience in live donor uterus transplantation is that the qualities of the uterus and the vasculature of the graft are critical factor for successful outcome of the transplantation procedure. Thus, the medical screening procedure to exclude possible cases with suboptimal donor organs is important for high success rate, in terms of transplantations that result in live births. This chapter reviews the current knowledge about several factors that have to be taken into account in screening for inclusion/exclusion of potential live donors. These factors include age, lifestyle factors, obstetric history, laboratory tests, cardiovascular examination, gynaecological examination and imaging modalities. © Springer Nature Switzerland AG 2020.
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| 3. |
- Brännström, Mats, 1958, et al.
(författare)
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Surgical technique of live donor in uterus transplantation
- 2020
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Ingår i: Uterus Transplantation. Brännström M. (red.). - Cham : Springer. - 9783319941622 ; , s. 111-117
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- One major part of surgery in uterus transplantation is surgery of the live donor. Early attempts have shown that this is the most challenging part of live donor uterus transplantation and the duration of donor surgery is around two times that of recipient surgery. Traditionally, live donor surgery was by laparotomy, but during the last few years minimal invasive surgery has gradually entered on the scene for donor surgery. Minimal invasive surgery has been both by traditional laparoscopy and by robotic-assisted laparoscopy. This chapter will review the technique of live donor surgery in uterus transplantation in detail. Complications that so far have been reported in donors will be discussed. There will be a continuous development in live donor surgery for uterus transplantation. These modifications will have positive impacts on surgical duration, tissue trauma, hospital stay, postoperative pain, time to return to common daily activities, and on rates of complications. © Springer Nature Switzerland AG 2020.
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| 4. |
- Brännström, Mats, 1958, et al.
(författare)
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Uterus transplantation as an infertility treatment
- 2023
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Ingår i: Human Reproductive and Prenatal Genetics. - 9780323913805 ; , s. 657-678
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Bokkapitel (refereegranskat)abstract
- Uterus transplantation (UTx) has during the past two decades evolved as the first treatment for absolute uterine factor infertility (AUFI). Our team started a step-by-step animal research project to understand if UTx was a feasible option and to optimize the procedure before possible introduction in the human. Research was initiated in rodents and was then further developed in animal models of larger domestic species and primates. In 2012, our team in Sweden launched the first clinical UTx trial and with the announcement of the world's first live birth after UTx in 2014. After that, several UTx trials were started and with results gradually evolving. In the present chapter, we will outline possible patient groups for UTx, surgery of UTx, clinical outcomes of trials and assisted reproduction in UTx patients.
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| 5. |
- Brännström, Mats, 1958, et al.
(författare)
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UTERUS TRANSPLANTATION: In Transition from Experimental to Clinical Procedure
- 2023
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Ingår i: Textbook of Assisted Reproductive Techniques: Volume 2: Clinical Perspectives, Sixth Edition. - 9781000933505 ; , s. 746-755
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Uterus transplantation (UTx) during the last decades has developed as a novel infertility treatment for absolute uterine factor infertility (AUFI) caused by absence of a functional uterus. After systematic animal research [1] over a decade, and involving rodents, domestic species, and non-human primates, the first clinical UTx trial was launched in 2013 [2]. This was a live donor (LD) UTx trial and one out of nine participating women gave birth to the world’s first UTx baby in September 2014 [3]. Since then, more than 10 clinical UTx trials have been initiated, with a mix between LD UTx and deceased donor (DD) UTx. Based on data from all registered ongoing trials and our personal experience, we describe plausible patient groups for UTx and cover different techniques of surgery and assisted reproduction in conjunction with UTx.
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| 6. |
- Dahm-Kähler, Pernilla, 1964, et al.
(författare)
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Indications and surgical technique for hysterectomy after uterus transplantation
- 2020
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Ingår i: Uterus Transplantation. Brännström, M. (red.). - Cham : Springer. - 9783319941622 ; , s. 209-214
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- A uterine allograft should at some stage be removed, even after proved functionality, in terms of harbouring a pregnancy with live birth. Thus, uterus transplantation is the first type of allogeneic organ transplantation that is ephemeral, with the graft not intended for life-long use. There are several situations when removal of an allogenic transplant is indicated, including early post-operative graft failure, severe and therapy-resistant rejection of the graft, severe non-uterine-specific complications/side-effects of immunosuppression, severe somatic illness, cases when the uterus has delivered the desired number of babies, and failure to successful pregnancy, usually after large number of implantation failures/miscarriages. Any hysterectomy should be performed by a gynaecologist together with a transplant surgeon that has participated in uterus transplantation surgery, so that the understanding of the specific and altered anatomy is secured. © Springer Nature Switzerland AG 2020.
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