Clinical trial NCT01844362: Uterus Transplantation From Live Donor
Official title: Prospective Case Series of Human Uterus Transplantation From Live Donor
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Primary Uterine Infertility
Keywords: uterus
transplantation
infertility
Lead sponsor: Sahlgrenska University Hospital
Sponsor class: OTHER
Collaborators: name: The Swedish Research Council
First posted: 2013-05-01
Enrollment: 9
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 39
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: Uterus transplantation, as a possible future treatment for uterine factor infertility, has been developed in animal species during the last decade.

The study protocol includes transplantation of the uterus from a live donor (mother, relative, friend) into women with absolute uterine factor infertility (lack of uterus from birth or due to life saving hysterectomy).The recipient will be treated by standard immunosuppression and transfer of embryos (acquired by IVF before surgery) will be attempted when at least 12 months have passed from transplantation. Approval for a case series including up to 10 patients has been acquired.

Detailed description: The study is ongoing, with inclusion of 9 patients.

Eligibility criteria: Inclusion Criteria:

* less than 39 years
* good general health

Exclusion Criteria:

* poor ovarian resaerve or older than 39 years
* systemic or psychiatric disease

Primary outcomes:
measure: surviving transplants (12 months)
timeFrame: up to 3 years after transplantation
Secondary outcomes:
measure: pregnancy rate
timeFrame: up to 3 years after transplantation
Other outcomes:
measure: live birth rate
timeFrame: up to 4 years after transplantation
Locations:
city: Göteborg
country: Sweden
facility: Mats Brännström
Study officials:
affiliation: Göteborg University
name: Mats Brännström, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Jarvholm S, Kattstrom A, Kvarnstrom N, Dahm-Kahler P, Brannstrom M. Long-term health-related quality-of-life and psychosocial outcomes after uterus transplantation: a 5-year follow-up of donors and recipients. Hum Reprod. 2024 Feb 1;39(2):374-381. doi: 10.1093/humrep/dead245.
citation: Jarvholm S, Bokstrom H, Enskog A, Hammarling C, Dahm-Kahler P, Brannstrom M. Striving for motherhood after uterus transplantation: a qualitative study concerning pregnancy attempts, and the first years of parenthood after transplantation. Hum Reprod. 2022 Jan 28;37(2):274-283. doi: 10.1093/humrep/deab260.
citation: Jarvholm S, Dahm-Kahler P, Kvarnstrom N, Brannstrom M. Psychosocial outcomes of uterine transplant recipients and partners up to 3 years after transplantation: results from the Swedish trial. Fertil Steril. 2020 Aug;114(2):407-415. doi: 10.1016/j.fertnstert.2020.03.043. Epub 2020 Jul 22.
citation: Jarvholm S, Enskog A, Hammarling C, Dahm-Kahler P, Brannstrom M. Uterus transplantation: joys and frustrations of becoming a 'complete' woman-a qualitative study regarding self-image in the 5-year period after transplantation. Hum Reprod. 2020 Aug 1;35(8):1855-1863. doi: 10.1093/humrep/deaa143.
citation: Jarvholm S, Kvarnstrom N, Dahm-Kahler P, Brannstrom M. Donors' health-related quality-of-life and psychosocial outcomes 3 years after uterus donation for transplantation. Hum Reprod. 2019 Jul 8;34(7):1270-1277. doi: 10.1093/humrep/dez087.
citation: Broecker V, Brannstrom M, Bosmuller H, Sticova E, Maluskova J, Chiesa-Vottero A, Molne J. Reproducibility of Rejection Grading in Uterus Transplantation: A Multicenter Study. Transplant Direct. 2023 Sep 20;9(10):e1535. doi: 10.1097/TXD.0000000000001535. eCollection 2023 Oct.
citation: Karlsson CC, Dahm-Kahler P, Kvarnstrom N, Molne J, Broecker V, Brannstrom M. Hysterectomy after uterus transplantation and detailed analyses of graft failures. Acta Obstet Gynecol Scand. 2022 Mar;101(3):355-363. doi: 10.1111/aogs.14304. Epub 2021 Dec 14.
citation: Broecker V, Brannstrom M, Ekberg J, Dahm-Kahler P, Molne J. Uterus transplantation: Histological findings in explants at elective hysterectomy. Am J Transplant. 2021 Feb;21(2):798-808. doi: 10.1111/ajt.16213. Epub 2020 Aug 11.
citation: Molne J, Broecker V, Ekberg J, Nilsson O, Dahm-Kahler P, Brannstrom M. Monitoring of Human Uterus Transplantation With Cervical Biopsies: A Provisional Scoring System for Rejection. Am J Transplant. 2017 Jun;17(6):1628-1636. doi: 10.1111/ajt.14135. Epub 2017 Jan 3.
citation: Brannstrom M, Bokstrom H, Dahm-Kahler P, Diaz-Garcia C, Ekberg J, Enskog A, Hagberg H, Johannesson L, Kvarnstrom N, Molne J, Olausson M, Olofsson JI, Rodriguez-Wallberg K. One uterus bridging three generations: first live birth after mother-to-daughter uterus transplantation. Fertil Steril. 2016 Aug;106(2):261-6. doi: 10.1016/j.fertnstert.2016.04.001. Epub 2016 Apr 25.
citation: Johannesson L, Kvarnstrom N, Molne J, Dahm-Kahler P, Enskog A, Diaz-Garcia C, Olausson M, Brannstrom M. Uterus transplantation trial: 1-year outcome. Fertil Steril. 2015 Jan;103(1):199-204. doi: 10.1016/j.fertnstert.2014.09.024. Epub 2014 Oct 22.
citation: Brannstrom M, Johannesson L, Bokstrom H, Kvarnstrom N, Molne J, Dahm-Kahler P, Enskog A, Milenkovic M, Ekberg J, Diaz-Garcia C, Gabel M, Hanafy A, Hagberg H, Olausson M, Nilsson L. Livebirth after uterus transplantation. Lancet. 2015 Feb 14;385(9968):607-616. doi: 10.1016/S0140-6736(14)61728-1. Epub 2014 Oct 6.
citation: Brannstrom M, Johannesson L, Dahm-Kahler P, Enskog A, Molne J, Kvarnstrom N, Diaz-Garcia C, Hanafy A, Lundmark C, Marcickiewicz J, Gabel M, Groth K, Akouri R, Eklind S, Holgersson J, Tzakis A, Olausson M. First clinical uterus transplantation trial: a six-month report. Fertil Steril. 2014 May;101(5):1228-36. doi: 10.1016/j.fertnstert.2014.02.024. Epub 2014 Feb 27.
citation: Jarvholm S, Johannesson L, Clarke A, Brannstrom M. Uterus transplantation trial: Psychological evaluation of recipients and partners during the post-transplantation year. Fertil Steril. 2015 Oct;104(4):1010-1015. doi: 10.1016/j.fertnstert.2015.06.038. Epub 2015 Jul 28.
citation: Jarvholm S, Johannesson L, Brannstrom M. Psychological aspects in pre-transplantation assessments of patients prior to entering the first uterus transplantation trial. Acta Obstet Gynecol Scand. 2015 Oct;94(10):1035-8. doi: 10.1111/aogs.12696. Epub 2015 Jun 30.
citation: Brannstrom M, Dahm-Kahler P, Kvarnstrom N, Enskog A, Olofsson JI, Olausson M, Molne J, Akouri R, Jarvholm S, Nilsson L, Stigson L, Hagberg H, Bokstrom H. Reproductive, obstetric, and long-term health outcome after uterus transplantation: results of the first clinical trial. Fertil Steril. 2022 Sep;118(3):576-585. doi: 10.1016/j.fertnstert.2022.05.017. Epub 2022 Jun 11.
citation: Davidson T, Ekberg J, Sandman L, Brannstrom M. The costs of human uterus transplantation: a study based on the nine cases of the initial Swedish live donor trial. Hum Reprod. 2021 Jan 25;36(2):358-366. doi: 10.1093/humrep/deaa301.