The first uterine transplant in Argentina will take place in Rosario

A team of professionals from Rosario are preparing for the first uterine transplant in Argentina, guided by the expert hand of Sweden's Mats Brännström, a world pioneer in uterine transplantation for reproductive purposes. The specialist was in the city training doctors who will participate in the intervention.

The practice, which has revolutionized the field of fertility in recent times, will take place next year at the Sanatorium Center.

The local project, which is already in its final stage, is led by Drs Gustavo Botti, Leticia Solari and Victoria Boccio, who belong to this institution. A large group of specialists will attend the intervention.

Although the recipient patient and the donor are not yet selected, local doctors know that there are women in the city (and in the region) willing to try to become biological mothers as well.

Beyond the ability of physicians and specific training to carry out this procedure, the legal aspect is essential. The Rosario were optimistic about the approval they needed from Incucai, the entity that authorizes and oversees all transplants nationwide.

For women without uterus, the possibility of becoming a mother, in addition to adoption, was through the subrogation of the uterus; now, grafting is an interesting alternative and is one of the major advances in fertility.

The experiments in which Brännström took part, who was the creator of the technique almost two decades ago, have for the most part been successful. Until now, about 60 uterine transplants have been performed worldwide. At least 13 of them allowed women who received the organ to give birth to perfectly healthy babies.

In Latin America, Brazil is the first antecedent of this type of transplant. On December 15, 2017, was born a girl whose mother had received a transplant from a deceased donor's uterus. Argentina is now poised to become the second largest country on the continent where this practice gives women the opportunity to continue their pregnancy without a uterus.

The causes

"Rokytansky's syndrome causes some women to be born without a uterus, most of these transplants have been performed with patients with this condition, and there are also people who may not have this organ-essential for pregnancy – for other problems, such as early removal due to cancer or other pathology, or bleeding, "said Dr. Gustavo Botti, in an interview with More. The fertility specialist has reported that, although the procedure can be performed with a deceased donor, it is also possible The mother, sister or friend of the patient are the donors. In Rosario, the idea is to opt for this alternative.

Expectations

In Gothenburg, Sweden, the first successful transplant took place. Brännström was in charge of being in all the details of what seemed, until that moment, typical of the futuristic novel.

In dialogue with this journal, the Swedish doctor told how this story began: "I was working in Australia, I had to intervene a young patient who underwent a total hysterectomy (removal of the uterus) and she asked me in a surprising way: "And why do not I have a transplant to make a uterus?" So, the idea was not mine, but that of a patient, "he remarked.

In 1999, Brännström and a team of experts started experimenting on animals, looking for the possibility of achieving, at a given moment, the implantation of the uterus from one woman to another. They gradually realized, in 2013, the first positive human experience that allowed the birth of a child.

The doctor explained that once pregnancy and delivery are complete, the uterus is permanently removed.

The first eight babies born from this technique come from Sweden. "There are two in Germany, one in China, two in Brazil …", said the specialist who estimates that about sixty transplants must already have been carried out in the world, including 30 in scientific journals prestigious.

He says that the procedure itself is not so complex and that the operation is not so expensive, and that its execution depends primarily on the will of the health zones of the countries that have to successful practice, in addition to medical training.

Botti explained that in Argentina, they had already submitted all the required documentation and that Incucai would certainly say yes in the short term. "I am convinced that they have all the resources to do it," added Brännström.

"The Argentine law on fertilization does not prohibit the transplantation of the uterus but does not specify it either. What we need is the Incucai agreement. We present this experimentally accompanied by a research protocol and hope that there will be support. In other countries (like Sweden), approval has been a fact for years, "said Botti.

The visit of Brännström encouraged the doctors of the sanatorium center to continue making progress in achieving their goal. The Rosario team will soon be traveling to Gothenburg and the world expert is due to return in 2020 to participate in the first transplant.

"There are already about six women from Rosario who have been interested. We will be able to evaluate them after the approval of the protocol, "said Botti.

"In addition, these patients are already discussing with their loved ones the possibility of being donors," said Leticia Solari and Victoria Boccio.

"When a woman who wants a pregnancy and can not get it by not having a uterus learns that this possibility exists, she gets really excited; That changes his face, it's very touching, "Botti said.

The steps

The Rosario Fertility Specialist mentioned that in addition to the transplant, it was necessary to perform badisted fertilization beforehand. "With the experience of the world – and that of Brännström – we are able to say that the procedure we wish to pursue has a good chance of success. From the surgical point of view, we have all the tools and the same aspect of the fertility treatment necessary to have the embryo that will be implanted in this uterus ".

"Patients should take immunosuppressive drugs, as in any transplant, but it's something that is also documented so that it does not generate adverse effects," Botti said.

The uterus can come from a deceased donor or a living donor (usually a direct relative of the patient or friend). "In the case of living donors, the situation is very difficult from an emotional point of view. It is a huge act of love. The truth is almost unbelievable, but you have to think that when the uterine donor is the recipient's mother, this woman will make the gestation of her son in the same uterus as the one she was in, "Botti said.

"One can think that in these situations, the body does not save a life as it can happen in the heart, kidneys, liver … After a pregnancy, I badure you that at least one modification of the quality of life is very similar to that of reliving, "said the professional.