Nation's First Uterus Transplant

Based on reporting by the Associated Press.

Surgeons in Cleveland say they have performed the nation's first uterus transplant — a new frontier aimed at giving women who lack wombs a chance at pregnancy.

In a statement Thursday, the Cleveland Clinic said the nine-hour surgery was performed a day earlier on a 26-year-old woman, using a uterus from a deceased donor. The hospital had long been planning such a surgery, having announced last fall a clinical trial that would attempt 10 transplants. No further details were to be released until a press conference the following week, beyond saying the woman's condition was stable.

Other countries had already tried womb transplants: Sweden reported the first successful birth in 2014, with a total of five healthy babies so far. Doctors there said the still-experimental treatment might be an alternative for some of the thousands of women unable to have children because they were born without a uterus or lost it to disease.

Others questioned whether such an extreme step would be a realistic option for many women. It is fraught with medical risk, including rejection of the transplant and the need to take potent immune-suppressing drugs for a transplant that, unlike a donated kidney or heart, isn't life-saving.

The Cleveland Clinic's Dr. Andreas Tzakis said the risks aren't greater than those of other transplants, but that the procedure is considered life-enhancing — like transplants of the face or hand.

One important difference: "Unlike any other transplants, they are 'ephemeral,'" Tzakis said in a statement announcing the study the previous year. "They are not intended to last for the duration of the recipient's life, but will be maintained for only as long as is necessary to produce one or two children."

Removing a uterus from a deceased donor requires more than a normal hysterectomy, since the major arteries must also be removed. The womb and blood vessels are sewn inside the recipient's pelvis, and before closing the abdomen, surgeons check for good blood flow and confirm the attachment to the ligaments is strong enough to maintain a pregnancy.

For women approved for the study, eggs would first be removed from their ovaries, as in in vitro fertilization, and the resulting embryos frozen. Those could be implanted only 12 months after the transplant heals, if it is successful. The trial was limited to women with uterine factor infertility — meaning they were born without a uterus or with uterine abnormalities that block pregnancy.

Update: The transplanted uterus was removed from the recipient on March 8, 2016, after she developed a sudden complication — a yeast infection that compromised the organ's blood supply. The Cleveland Clinic continued the trial, and later that year reported it would resume transplants after the setback.