Uterine transplantation-a real possibility? the Indianapolis consensus

Giuseppe Del Priore, Srdjan Saso, Eric M. Meslin, Andreas Tzakis, Mats Brännström, Alex Clarke, Rodrigo Vianna, Renata Sawyer, J. Richard Smith

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

A group of experts gathered in Indianapolis in December 2011 to address lingering concerns related to uterus transplantation (UTn). They represent a multi-national group of four research teams who have worked for over 15 years on bringing UTn to reality for patients. Presented here are a set of parameters that must be considered in order for UTn to become an acceptable procedure in the human setting. UTn has been proposed as a potential solution to absolute uterine factor infertility (AUFI). Causes of AUFI include congenital uterine factors (i.e. absence or malformation) or acquired uterine factors (e.g. hysterectomy for uncontrollable hemorrhage) rendering a woman 'unconditionally infertile'. Current estimates are that in the USA, up to 7 million women with AUFI may be appropriate candidates for UTn. As a result of a first human attempt in 2000, investigators have responded with a plethora of publications demonstrating successful UTn attempts, including pregnancies, in various autogeneic, syngeneic and allogeneic animal models. Before UTn can become an accepted procedure, it must satisfy defined criteria for any surgical innovation, i.e. research Background , field strength and institutional stability. Equally important, UTn must satisfy accepted bioethical principles (respect for autonomy, beneficence, non-maleficence and justice) and their application (informed consent, appropriate assessment of risk and benefit and fair selection of individuals). Furthermore, we believe that a defined number of transplants should not be exceeded worldwide without a successful term delivery, to minimize proceeding in futility using current techniques. Even if UTns were to become relatively common, the following research objectives should be continuously pursued: (i) additional pregnancies in a variety of large animal/primate models (to search for unanticipated consequences), (ii) continuous assessment of women diagnosed with AUFI regarding UTn, (iii) continuous assessment using 'borrowed' psychological tools from transplant centers, adoption agencies and assisted reproductive technology centers with potential recipients and (iv) continuous careful ethical reflection, assessment and approval.

Original languageEnglish
Pages (from-to)288-291
Number of pages4
JournalHuman Reproduction
Volume28
Issue number2
DOIs
StatePublished - Feb 2013

Fingerprint

Uterus
Transplantation
Infertility
Animal Models
Research
Medical Futility
Beneficence
Transplants
Pregnancy
Assisted Reproductive Techniques
Social Justice
Informed Consent
Hysterectomy
Primates
Publications
Research Personnel
Hemorrhage
Psychology

Keywords

  • female infertility
  • transplantation
  • uterus

ASJC Scopus subject areas

  • Rehabilitation
  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Del Priore, G., Saso, S., Meslin, E. M., Tzakis, A., Brännström, M., Clarke, A., ... Richard Smith, J. (2013). Uterine transplantation-a real possibility? the Indianapolis consensus. Human Reproduction, 28(2), 288-291. https://doi.org/10.1093/humrep/des406

Uterine transplantation-a real possibility? the Indianapolis consensus. / Del Priore, Giuseppe; Saso, Srdjan; Meslin, Eric M.; Tzakis, Andreas; Brännström, Mats; Clarke, Alex; Vianna, Rodrigo; Sawyer, Renata; Richard Smith, J.

In: Human Reproduction, Vol. 28, No. 2, 02.2013, p. 288-291.

Research output: Contribution to journalArticle

Del Priore, G, Saso, S, Meslin, EM, Tzakis, A, Brännström, M, Clarke, A, Vianna, R, Sawyer, R & Richard Smith, J 2013, 'Uterine transplantation-a real possibility? the Indianapolis consensus', Human Reproduction, vol. 28, no. 2, pp. 288-291. https://doi.org/10.1093/humrep/des406
Del Priore G, Saso S, Meslin EM, Tzakis A, Brännström M, Clarke A et al. Uterine transplantation-a real possibility? the Indianapolis consensus. Human Reproduction. 2013 Feb;28(2):288-291. https://doi.org/10.1093/humrep/des406
Del Priore, Giuseppe ; Saso, Srdjan ; Meslin, Eric M. ; Tzakis, Andreas ; Brännström, Mats ; Clarke, Alex ; Vianna, Rodrigo ; Sawyer, Renata ; Richard Smith, J. / Uterine transplantation-a real possibility? the Indianapolis consensus. In: Human Reproduction. 2013 ; Vol. 28, No. 2. pp. 288-291.
@article{296dada5058543ada82a412fdd8e2170,
title = "Uterine transplantation-a real possibility? the Indianapolis consensus",
abstract = "A group of experts gathered in Indianapolis in December 2011 to address lingering concerns related to uterus transplantation (UTn). They represent a multi-national group of four research teams who have worked for over 15 years on bringing UTn to reality for patients. Presented here are a set of parameters that must be considered in order for UTn to become an acceptable procedure in the human setting. UTn has been proposed as a potential solution to absolute uterine factor infertility (AUFI). Causes of AUFI include congenital uterine factors (i.e. absence or malformation) or acquired uterine factors (e.g. hysterectomy for uncontrollable hemorrhage) rendering a woman 'unconditionally infertile'. Current estimates are that in the USA, up to 7 million women with AUFI may be appropriate candidates for UTn. As a result of a first human attempt in 2000, investigators have responded with a plethora of publications demonstrating successful UTn attempts, including pregnancies, in various autogeneic, syngeneic and allogeneic animal models. Before UTn can become an accepted procedure, it must satisfy defined criteria for any surgical innovation, i.e. research Background , field strength and institutional stability. Equally important, UTn must satisfy accepted bioethical principles (respect for autonomy, beneficence, non-maleficence and justice) and their application (informed consent, appropriate assessment of risk and benefit and fair selection of individuals). Furthermore, we believe that a defined number of transplants should not be exceeded worldwide without a successful term delivery, to minimize proceeding in futility using current techniques. Even if UTns were to become relatively common, the following research objectives should be continuously pursued: (i) additional pregnancies in a variety of large animal/primate models (to search for unanticipated consequences), (ii) continuous assessment of women diagnosed with AUFI regarding UTn, (iii) continuous assessment using 'borrowed' psychological tools from transplant centers, adoption agencies and assisted reproductive technology centers with potential recipients and (iv) continuous careful ethical reflection, assessment and approval.",
keywords = "female infertility, transplantation, uterus",
author = "{Del Priore}, Giuseppe and Srdjan Saso and Meslin, {Eric M.} and Andreas Tzakis and Mats Br{\"a}nnstr{\"o}m and Alex Clarke and Rodrigo Vianna and Renata Sawyer and {Richard Smith}, J.",
year = "2013",
month = "2",
doi = "10.1093/humrep/des406",
language = "English",
volume = "28",
pages = "288--291",
journal = "Human Reproduction",
issn = "0268-1161",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Uterine transplantation-a real possibility? the Indianapolis consensus

AU - Del Priore, Giuseppe

AU - Saso, Srdjan

AU - Meslin, Eric M.

AU - Tzakis, Andreas

AU - Brännström, Mats

AU - Clarke, Alex

AU - Vianna, Rodrigo

AU - Sawyer, Renata

AU - Richard Smith, J.

PY - 2013/2

Y1 - 2013/2

N2 - A group of experts gathered in Indianapolis in December 2011 to address lingering concerns related to uterus transplantation (UTn). They represent a multi-national group of four research teams who have worked for over 15 years on bringing UTn to reality for patients. Presented here are a set of parameters that must be considered in order for UTn to become an acceptable procedure in the human setting. UTn has been proposed as a potential solution to absolute uterine factor infertility (AUFI). Causes of AUFI include congenital uterine factors (i.e. absence or malformation) or acquired uterine factors (e.g. hysterectomy for uncontrollable hemorrhage) rendering a woman 'unconditionally infertile'. Current estimates are that in the USA, up to 7 million women with AUFI may be appropriate candidates for UTn. As a result of a first human attempt in 2000, investigators have responded with a plethora of publications demonstrating successful UTn attempts, including pregnancies, in various autogeneic, syngeneic and allogeneic animal models. Before UTn can become an accepted procedure, it must satisfy defined criteria for any surgical innovation, i.e. research Background , field strength and institutional stability. Equally important, UTn must satisfy accepted bioethical principles (respect for autonomy, beneficence, non-maleficence and justice) and their application (informed consent, appropriate assessment of risk and benefit and fair selection of individuals). Furthermore, we believe that a defined number of transplants should not be exceeded worldwide without a successful term delivery, to minimize proceeding in futility using current techniques. Even if UTns were to become relatively common, the following research objectives should be continuously pursued: (i) additional pregnancies in a variety of large animal/primate models (to search for unanticipated consequences), (ii) continuous assessment of women diagnosed with AUFI regarding UTn, (iii) continuous assessment using 'borrowed' psychological tools from transplant centers, adoption agencies and assisted reproductive technology centers with potential recipients and (iv) continuous careful ethical reflection, assessment and approval.

AB - A group of experts gathered in Indianapolis in December 2011 to address lingering concerns related to uterus transplantation (UTn). They represent a multi-national group of four research teams who have worked for over 15 years on bringing UTn to reality for patients. Presented here are a set of parameters that must be considered in order for UTn to become an acceptable procedure in the human setting. UTn has been proposed as a potential solution to absolute uterine factor infertility (AUFI). Causes of AUFI include congenital uterine factors (i.e. absence or malformation) or acquired uterine factors (e.g. hysterectomy for uncontrollable hemorrhage) rendering a woman 'unconditionally infertile'. Current estimates are that in the USA, up to 7 million women with AUFI may be appropriate candidates for UTn. As a result of a first human attempt in 2000, investigators have responded with a plethora of publications demonstrating successful UTn attempts, including pregnancies, in various autogeneic, syngeneic and allogeneic animal models. Before UTn can become an accepted procedure, it must satisfy defined criteria for any surgical innovation, i.e. research Background , field strength and institutional stability. Equally important, UTn must satisfy accepted bioethical principles (respect for autonomy, beneficence, non-maleficence and justice) and their application (informed consent, appropriate assessment of risk and benefit and fair selection of individuals). Furthermore, we believe that a defined number of transplants should not be exceeded worldwide without a successful term delivery, to minimize proceeding in futility using current techniques. Even if UTns were to become relatively common, the following research objectives should be continuously pursued: (i) additional pregnancies in a variety of large animal/primate models (to search for unanticipated consequences), (ii) continuous assessment of women diagnosed with AUFI regarding UTn, (iii) continuous assessment using 'borrowed' psychological tools from transplant centers, adoption agencies and assisted reproductive technology centers with potential recipients and (iv) continuous careful ethical reflection, assessment and approval.

KW - female infertility

KW - transplantation

KW - uterus

UR - http://www.scopus.com/inward/record.url?scp=84872584792&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84872584792&partnerID=8YFLogxK

U2 - 10.1093/humrep/des406

DO - 10.1093/humrep/des406

M3 - Article

VL - 28

SP - 288

EP - 291

JO - Human Reproduction

JF - Human Reproduction

SN - 0268-1161

IS - 2

ER -