Living Donor Uterus Transplantation.

Abstract

For women with absolute uterine factor infertility, uterus transplantation represents the closest solution to normal gestation and delivery. It is a temporary transplant; the uterine graft is removed after completion of childbearing. The uterus transplant journey involves multiple surgical and medical steps. The surgical steps include living or deceased donor hysterectomy, transplant of the uterine graft, cesarean delivery, and graft hysterectomy. The medical steps include immunosuppressive treatment, in vitro fertilization, and pregnancy. In this video, we show a living donor uterus transplant, including donor hysterectomy, back-table preparation of the uterine graft, and recipient transplant surgery. The video highlights the surgical steps of the procedure. Between September 2016 and January 2025, 36 women underwent uterus transplantation at Baylor University Medical Center, resulting in the birth of 26 children to date. Uterus transplantation is associated with successful births of healthy children.