{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:32:47Z","timestamp":1792805567755,"version":"4.5.0"},"reference-count":18,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,4,11]],"date-time":"2023-04-11T00:00:00Z","timestamp":1681171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Akdeniz University Medical Education Development Association","id":[{"id":"https:\/\/ror.org\/01m59r132","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Uterus-related infertility affects 3\u20135% of all young women, including Mayer-Rokitansky-K\u00fcster-Hauser (MRKH) syndrome, hysterectomy, or severe Asherman syndrome. For these women with uterus-related infertility, uterus transplantation is now a viable option. We performed the first surgically successful uterus transplant in September 2011. The Donor was a 22-year-old nulliparous woman. After five failed pregnancy attempts (pregnancy losses), ET attempts were discontinued in the first case, and a search for underlying etiology was performed, including static and dynamic imaging studies. Perfusion computed tomography revealed an obstructed blood outflow, particularly in the left anterolateral part of the uterus. In order to correct blood flow obstruction, a revision surgery was planned. By laparotomy, a saphenous vein graft was anastomosed between the left utero-ovarian and left ovarian vein. Perfusion computed tomography performed after the revision surgery confirmed the resolution of venous congestion and a decrease in uterine volume as well. Following surgical intervention, the patient was able to conceive after the first embryo transfer attempt. The baby was delivered with cesarean section at 28 weeks\u2019 gestation due to intrauterine growth restriction and abnormal Doppler ultrasonography findings. Following this case, our team performed the second uterus transplantation in July 2021. The recipient was a 32-year-old female with MRKH syndrome, and the donor was a 37-year-old multiparous braindead woman due to intracranial bleeding. After the transplant surgery, the second patient experienced menstrual bleeding six weeks after the operation. Seven months after the transplant, in the first ET attempt, pregnancy was achieved, and she delivered a healthy baby at 29 weeks of pregnancy. Uterus transplantation from a deceased donor is a feasible option for treating uterus-related infertility. When confronted with recurrent pregnancy losses, vascular revision surgery via arterial or venous supercharging could be an option in order to deal with focal underperfused areas defined by imaging studies.<\/jats:p>","DOI":"10.3390\/jcm12082812","type":"journal-article","created":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T02:08:11Z","timestamp":1681265291000},"page":"2812","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The Ozkan Technique in Current Use in Uterus Transplantation: From the First Ever Successful Attempt to Clinical Reality"],"prefix":"10.3390","volume":"12","author":[{"given":"Omer","family":"Ozkan","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Faculty of Medicine, Akdeniz University, 07070 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozlenen","family":"Ozkan","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Faculty of Medicine, Akdeniz University, 07070 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasuh Utku","family":"Dogan","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Faculty of Medicine, Akdeniz University, 07070 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,11]]},"reference":[{"key":"ref_1","first-page":"442","article-title":"Uterus transplantation: From animal models through the first heart beating pregnancy to the first human live birth","volume":"12","author":"Ozkan","year":"2016","journal-title":"Women\u2019s Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0020-7292(01)00597-5","article-title":"Transplantation of the human uterus","volume":"76","author":"Fageeh","year":"2002","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.fertnstert.2012.09.035","article-title":"Preliminary results of the first human uterus transplantation from a multiorgan donor","volume":"99","author":"Ozkan","year":"2013","journal-title":"Fertil. Steril."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/S0140-6736(14)61728-1","article-title":"Livebirth after uterus transplantation","volume":"385","author":"Brannstrom","year":"2015","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2697","DOI":"10.1016\/S0140-6736(18)31766-5","article-title":"Livebirth after uterus transplantation from a deceased donor in a recipient with uterine infertility","volume":"392","author":"Ejzenberg","year":"2019","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1097\/SLA.0000000000005346","article-title":"Birth of a Healthy Baby 9 Years After a Surgically Successful Deceased Donor Uterus Transplant","volume":"275","author":"Ozkan","year":"2021","journal-title":"Ann. Surg."},{"key":"ref_7","first-page":"e12772","article-title":"A New Approach for Treatment of Woman With Absolute Uterine Factor Infertility: A Traditional Review of Safety and Efficacy Outcomes in the First 65 Recipients of Uterus Transplantation","volume":"13","author":"Malasevskaia","year":"2021","journal-title":"Cureus"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1016\/j.fertnstert.2014.02.024","article-title":"First clinical uterus transplantation trial: A six-month report","volume":"101","author":"Johannesson","year":"2014","journal-title":"Fertil. Steril."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1016\/j.fertnstert.2020.05.027","article-title":"Evolution of surgical steps in robotics-assisted donor surgery for uterus transplantation: Results of the eight cases in the Swedish trial","volume":"114","author":"Groth","year":"2020","journal-title":"Fertil. Steril."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1111\/ajt.15096","article-title":"Revaluation and lessons learned from the first 9 cases of a Czech uterus transplantation trial: Four deceased donor and 5 living donor uterus transplantations","volume":"19","author":"Chmel","year":"2019","journal-title":"Am. J. Transplant."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/j.jmig.2018.11.021","article-title":"Novel Anastomotic Technique for Uterine Transplant Using Utero-ovarian Veins for Venous Drainage and Internal Iliac Arteries for Perfusion in Two Laparoscopically Harvested Uteri","volume":"26","author":"Puntambekar","year":"2019","journal-title":"J. Minim. Invasive Gynecol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/j.fertnstert.2017.05.039","article-title":"Modified human uterus transplantation using ovarian veins for venous drainage: The first report of surgically successful robotic-assisted uterus procurement and follow-up for 12 months","volume":"108","author":"Wei","year":"2017","journal-title":"Fertil. Steril."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.jogoh.2018.03.006","article-title":"Uterine transplantation: Review in human research","volume":"47","author":"Rafii","year":"2018","journal-title":"J. Gynecol. Obstet. Hum. Reprod."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Daolio, J., Palomba, S., Paganelli, S., Falbo, A., and Aguzzoli, L. (2020). Uterine transplantation and IVF for congenital or acquired uterine factor infertility: A systematic review of safety and efficacy outcomes in the first 52 recipients. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0232323"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/j.jpag.2020.03.006","article-title":"Assisted Reproductive Techniques and Pregnancy Results in Women with Mayer-Rokitansky-K\u00fcster-Hauser Syndrome Undergoing Uterus Transplantation: The Czech Experience","volume":"33","author":"Chmel","year":"2020","journal-title":"J. Pediatr. Adolesc. Gynecol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/j.1523-1755.2004.00741.x","article-title":"Risk of malignancy with long-term immunosuppression in renal transplant recipients","volume":"66","author":"Agraharkar","year":"2004","journal-title":"Kidney Int."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1001\/jama.2011.1592","article-title":"Spectrum of Cancer Risk Among US Solid Organ Transplant Recipients","volume":"306","author":"Engels","year":"2011","journal-title":"JAMA"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1097\/SLA.0000000000005401","article-title":"The History of Uterus Transplantation, Rewritten","volume":"275","author":"Testa","year":"2022","journal-title":"Ann. 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