{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:02:41Z","timestamp":1791464561779,"version":"4.3.4"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2024-03487"],"award-info":[{"award-number":["2024-03487"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Jane and Dan Olsson Foundation","award":["2024-11"],"award-info":[{"award-number":["2024-11"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>STUDY QUESTION<\/jats:title>\n                    <jats:p>What have been the activities, characteristics, and outcomes of uterus transplantation (UTx) performed worldwide from 2000 through 2024?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>SUMMARY ANSWER<\/jats:title>\n                    <jats:p>In 91 UTx cases, 67 involved live donors and 80 of the recipients had Mayer-Rokitansky-K\u00fcster-Hauser syndrome, with 12-month graft survival of 74%, enabling pregnancy attempts that yielded 44 healthy singleton deliveries with a live birth rate per embryo transfer of 30.3%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WHAT IS KNOWN ALREADY<\/jats:title>\n                    <jats:p>UTx is the only treatment for women with absolute uterine factor infertility who wish to carry a pregnancy. According to a comprehensive report including data up to 2020 on 45 UTx cases, 19 live births occurred (35.8% per embryo transfer) at a mean of 35.3\u2009weeks gestation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY DESIGN, SIZE, DURATION<\/jats:title>\n                    <jats:p>Data were extracted from the web-based registry of the International Society of Uterus Transplantation (ISUTx). This registry captures information on donor and recipient characteristics, transplantation procedures, postoperative complications, immunosuppression, complications including rejections, and reproductive outcome. Analyses were undertaken of the 91 transplants performed between 6 April 2000 and 31 December 2024, that were recorded in the registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PARTICIPANTS\/MATERIALS, SETTING, METHODS<\/jats:title>\n                    <jats:p>Twenty-four medical centers in five continents registered their uterus transplants by entering data from the day of transplantation until 3\u2009months after graft removal. The following variables were assessed: the demographic and laboratory characteristics of donors and recipients, the source of graft (live versus deceased donor), surgical specifics including technique, duration, ischemic times, and post-op complications, immunosuppression, rejection data, pregnancy with live birth(s), and hysterectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>MAIN RESULTS AND THE ROLE OF CHANCE<\/jats:title>\n                    <jats:p>In 91 uterus transplantations (67 from live donors, 24 from deceased donors), the overall surgical success rate, defined as graft viability by 12\u2009months, was 75%. Most recipients (88%) had Mayer-Rokitansky-K\u00fcster-Hauser syndrome, with mothers being the most frequent (64%) live donors. Live donor hysterectomies were performed by laparotomy (54%), robotics (28%), or laparoscopy (18%). Total ischemic time was shorter in live- versus deceased-donor UTx procedures. Rejection episodes that were treated with escalations of immunosuppression were more frequent during months 1\u20135 (44%) than during months 6\u201310 (28%) post-UTx. Graft survival during the first 12\u2009months was superior when grafts from premenopausal donors were used as compared to from postmenopausal donors. Forty-four singleton live births (mean gestational length of 34.5\u2009weeks), including eight second births, were reported, with a live birth rate per embryo transfer of 30%. Preeclampsia was the most common pregnancy complication, occurring in 23% of live-birth pregnancies. Major postnatal complications occurred in 11 infants, 9 with respiratory distress syndrome; no major malformations were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LIMITATIONS, REASONS FOR CAUTION<\/jats:title>\n                    <jats:p>Data in the registry are self-reported and not subjected to validation. Although the ISUTx registry represents the most comprehensive quality registry of UTx activity in the world, cases from at least four centers are excluded as they were not entered into the registry. Birth outcomes from some registry cases are as yet unknown as these ongoing cases have not yet reached the endpoint of hysterectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>WIDER IMPLICATIONS OF THE FINDINGS<\/jats:title>\n                    <jats:p>This study presents the most comprehensive analysis to date of UTx, the only fertility treatment for absolute uterine factor infertility. The registry serves as the prime source for quality assessment and process improvement in UTx.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>STUDY FUNDING\/COMPETING INTEREST(S)<\/jats:title>\n                    <jats:p>The establishment and operation of the registry were funded by the Swedish Research Council (2024-03487 to M.B.) and Jane and Dan Olsson Foundation (2024-11 to M.B.). There was no competing interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>TRIAL REGISTRATION NUMBER<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/humrep\/deag017","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T12:13:17Z","timestamp":1769515997000},"page":"541-551","source":"Crossref","is-referenced-by-count":14,"title":["Second report of registry of the International Society of Uterus Transplantation (ISUTx): international activities 2000\u20132024"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6081-9101","authenticated-orcid":false,"given":"Mats","family":"Br\u00e4nnstr\u00f6m","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg , G\u00f6teborg,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8961-7896","authenticated-orcid":false,"given":"Catherine","family":"Racowsky","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School , Boston, MA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Wiik","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg , G\u00f6teborg,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan G","family":"Tullius","sequence":"additional","affiliation":[{"name":"Division of Transplant Surgery, Brigham and Women\u2019s Hospital, Harvard Medical School , Boston, MA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Deans","sequence":"additional","affiliation":[{"name":"Royal Hospital for Women, University of New South Wales , Sydney, NSW,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige M","family":"Porrett","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Alabama at Birmingham , Birmingham, AL,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wellington","family":"Andraus","sequence":"additional","affiliation":[{"name":"Digestive Organs Transplant Division, Gastroenterology Department, University of S\u00e3o Paulo School of Medicine FM-USP , S\u00e3o Paulo,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tan Hak","family":"Koon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Singapore General Hospital , Singapore,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Carmona","sequence":"additional","affiliation":[{"name":"Institute Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clinic de Barcelona, Institut d\u00cdnvestigacions Biom\u00e8diques August Pi i Sunyer, Universitat de Barcelona , Barcelona,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randa","family":"Akouri","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg , G\u00f6teborg,","place":["Sweden"]},{"name":"Bellevue Medical Center, St. Joseph University , Beirut,","place":["Lebanon"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Scollo","sequence":"additional","affiliation":[{"name":"Division of Gynecology and Obstetrics, Maternal and Child Department, Cannizzaro Hospital , Catania,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smit","family":"Solanki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute of Kidney Diseases and Research Center, Dr. H.L. 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