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- W2775268081 abstract "Uterus transplantation (UTx) is a novel procedure that may provide a treatment of absolute uterine factor infertility (AUFI). AUFI, due to absence of, or presence of a non-functional, uterus, is today the only major untreatable group of female infertility and affects 1/500 of fertile aged women (around 85 000 women in the US). Nine human live donor UTx, were performed during 2012-2013. In two patients the uteri were removed within 4 months post transplantation. The remaining 7 are viable after 12 months. IS followed a protocol of induction with 500 mg methylprednisolone and either 2,5 mg/kg bw Thymoglobulin or 5 mg/kg bw ATG twice. Maintenance therapy was with tacrolimus (adjusted to trough levels of 10-15 ng/ml during week 1-5 and 5-10 ng/ml from week 6) and mycophenolate mofetil with trough levels of 40-60 mg×h/L. Additional oral glucocorticosteroids was given during the first postop week. After 6-9 months we aimed to introduce monotherapy with tacrolimus. In 3 patients this was not possible due to rejection episodes, and mycophenolate mofetil was replaced with azathioprine. The recipients were monitored by clinical examination twice weekly during the first month, once weekly during months 2-3, and thereafter every second week. The examinations comprised blood tests, ultrasound, visual inspection, bacterial culture and biopsies. Rejection was diagnosed based on cervical biopsies and severity of acute rejection was scored, from none to severe, according to a subjective 4-step-scale (based on rejection characteristics in other organs and uterine rejection in several animal species). In four patients mild rejection episodes occurred. The episodes were asymptomatic, with normal results on ultrasound and gynecological examination. Morphological analysis of the cervical tissue showed mild infiltration of lymphocytes and neutrophils, mainly in the basal squamous epithelium of the ectocervix. All rejection episodes were successfully treated with a tapering corticosteroid protocol for 7-10 days with initial boluses. In conclusion, the trial demonstrate the feasibility of live donor UTx with a low dose immunosuppressive protocol. Rejection episodes were detected with cervical biopsies and resolvable when detected in time." @default.
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- W2775268081 date "2014-07-01" @default.
- W2775268081 modified "2023-10-18" @default.
- W2775268081 title "Human Uterus Transplantation Trial: Monitoring, Rejection Episodes and Immunosuppression During 1 Year." @default.
- W2775268081 doi "https://doi.org/10.1097/00007890-201407151-00040" @default.
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