Abstract
Being inherently different from any other lifesaving organ transplant, uterine transplantation does not aim at saving lives but supporting the possibility to generate life. Unlike the kidneys or the liver, the uterus is not specifically a vital organ. Given the non-lifesaving nature of this procedure, questions have been raised about its feasibility. The ethical dilemma revolves around whether it is worth placing two lives at risk related to surgery and immunosuppression, amongst others, to enable a woman with absolute uterine factor infertility to experience the presence of an organ enabling childbirth. In the year 2000, the first uterine transplantation, albeit unsuccessful, was performed in Saudi Arabia from where it has spread to the rest of the world including Sweden, the United States and now recently India. The procedure is, however, still in the preclinical stages and several ethical, legal, social and religious concerns are yet to be addressed before it can be integrated into the clinical setting as standard of care for women with absolute uterine factor infertility.
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Appelbaum, P. S., Roth, L. H., Lidz, C. W., Benson, P., & Winslade, W. (1987). False hopes and best data: Consent to research and the therapeutic misconception. The Hastings Center Report, 17, 20–24.
Arora, M. (2017). Mom donates womb to daughter in India’s first uterus transplant. CNN News. http://edition.cnn.com/2017/05/19/health/india-uterus-womb-transplant/index.html. Accessed 29 August 2017.
Brannstrom, M. (2015). Uterus transplantation. Current opinion in organ transplantation, 20, 621–628.
Brannstrom, M. (2017). Uterus transplantation and beyond. Journal of Materials Science Materials in Medicine, 28, 70.
Brannstrom, M., Bokstrom, H., Dahm-Kahler, P., Diaz-Garcia, C., Ekberg, J., Enskog, A., et al. (2016). One uterus bridging three generations: First live birth after mother-to-daughter uterus transplantation. Fertility and Sterility, 106, 261–266.
Brannstrom, M., Johannesson, L., Bokstrom, H., Kvarnstrom, N., Molne, J., Dahm-Kahler, P., et al. (2015). Livebirth after uterus transplantation. Lancet, 385, 607–616.
Brannstrom, M., Johannesson, L., Dahm-Kahler, P., Enskog, A., Molne, J., Kvarnstrom, N., et al. (2014). First clinical uterus transplantation trial: A six-month report. Fertility and Sterility, 101, 1228–1236.
Del Priore, G., & Gudipudi, D. K. (2014). Promise of uterine transplant–myth or a reality? Maturitas, 77, 20–23.
Dickens, B. M. (2016). Legal and ethical issues of uterus transplantation. International Journal of Gynecology and Obstetrics, 133, 125–128.
El-Akouri, R. R., Kurlberg, G., Dindelegan, G., Molne, J., Wallin, A., & Bransstrom, M. (2002). Heterotopic uterine transplantation by vascular anastomosis in the mouse. Journal of Endocrinology, 174, 157–166.
Enskog, A., Johannesson, L., Chai, D. C., Dahm-Kahler, P., Marcickiewicz, J., Nyachieo, A., et al. (2010). Uterus transplantation in the baboon: Methodology and long-term function after auto-transplantation. Human Reproduction, 25, 1980–1987.
Fageeh, W., Raffa, H., Jabbad, H., & Marzouki, A. (2002). Transplantation of the human uterus. International Journal of Gynecology and Obstetrics, 76, 245–251.
Gauthier, T., Garnault, D., Therme, J. F., Piver, P., Essig, M., Pichon, N., et al. (2015). Uterine transplantation: Is there a real demand? Gynecologie Obstetrique and Fertilite, 43, 133–138.
GBD 2015 Healthcare Access and Quality Collaborators. (2017). Healthcare access and quality index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: A novel analysis from the global burden of disease study 2015. Lancet, 390, 231–266.
Gilbert, F., O’Connell, C. D., Mladenovska, T., & Dodds, S. (2017). Print me an organ? Ethical and regulatory issues emerging from 3D bioprinting in medicine. Science and Engineering Ethics. https://doi.org/10.1007/s11948-017-9874-6.
Isa, N. M. (2016). Darurah (necessity) and its application in Islamic ethical assessment of medical applications: A review on Malaysian Fatwa. Science and Engineering Ethics, 22, 1319–1332.
Johannesson, L., Enskog, A., Dahm-Kahler, P., Hanafy, A., Chai, D. C., Mwenda, J. M., et al. (2012). Uterus transplantation in a non-human primate: Long-term follow-up after autologous transplantation. Human Reproduction, 27, 1640–1648.
Johannesson, L., Enskog, A., Molne, J., Diaz-Garcia, C., Hanafy, A., Dahm-Kahler, P., et al. (2013). Pre-clinical report on allogeneic uterus transplantation in non-human primates. Human Reproduction, 28, 189–198.
Joshi, Y., & Pandit, S. (2017). 21-year-old Pune woman gets mother’s womb in India’s first uterus transplant. Hindustan Times. http://www.hindustantimes.com/mumbai-news/21-year-old-pune-woman-gets-mother-s-womb-in-india-s-first-uterus-transplant/story-4jIBAKjxtx89So9VFdDEBJ.html. Accessed 29 August 2017.
Lavoue, V., Vigneau, C., Duros, S., Boudjema, K., Leveque, J., Piver, P., et al. (2017). Which donor for uterus transplants: Brain-dead donor or living donor? A systematic review. Transplantation, 101, 267–273.
Lefkowitz, A., Edwards, M., & Balayla, J. (2012). The Montreal criteria for the ethical feasibility of uterine transplantation. Transplant International, 25, 439–447.
Menezes, R. G., Bhagavath, P., & Adiga, P. K. (2007). Surrogacy in India. Journal of Forensic and Legal Medicine, 14, 307.
Milliez, J. (2009). Uterine transplantation FIGO committee for the ethical aspects of human reproduction and women’s health. International Journal of Gynecology and Obstetrics, 106, 270.
Olausson, M., Johannesson, L., Brattgard, D., Diaz-Garcia, C., Lundmark, C., Groth, K., et al. (2014). Ethics of uterus transplantation with live donors. Fertility and Sterility, 102, 40–43.
Petrini, C., Gainotti, S., Morresi, A., & Costa, A. N. (2017). Ethical issues in uterine transplantation: Psychological implications and informed consent. Transplantation Proceedings, 49, 707–710.
Tryphonopoulos, P., Tzakis, A. G., Tekin, A., Johannesson, L., Rivas, K., Morales, P. R., et al. (2014). Allogeneic uterus transplantation in baboons: Surgical technique and challenges to long-term graft survival. Transplantation, 98, e51–e56.
Wranning, C. A., El-Akouri, R. R., Lundmark, C., Dahm-Kahler, P., Molne, J., Enskog, A., et al. (2006). Auto-transplantation of the uterus in the domestic pig (Sus scrofa): Surgical technique and early reperfusion events. Journal of Obstetrics and Gynaecology Research, 32, 358–367.
Wranning, C. A., Marcickiewicz, J., Enskog, A., Dahm-Kahler, P., Hanafy, A., & Brannstrom, M. (2010). Fertility after autologous ovine uterine–tubal–ovarian transplantation by vascular anastomosis to the external iliac vessels. Human Reproduction, 25, 1973–1979.
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Taneja, A., Das, S., Hussain, S.A. et al. Uterine Transplant: A Risk to Life or a Chance for Life?. Sci Eng Ethics 25, 635–642 (2019). https://doi.org/10.1007/s11948-018-0018-4
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DOI: https://doi.org/10.1007/s11948-018-0018-4