{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:00:16Z","timestamp":1793070016846,"version":"4.5.0"},"reference-count":37,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T00:00:00Z","timestamp":1596412800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Uterus transplantation (UTx) can provide a route to motherhood for women with Mayer\u2013Rokitansky\u2013K\u00fcster\u2013Hauser syndrome (MRKHS), a congenital disorder characterized by uterovaginal aplasia, but with functional ovaries. Based on our four successful living-donor transplantations and two resulting births, this analysis presents parameters relevant to standardizing recipient\/donor selection, UTx surgery, and postoperative treatment, and their implementation in routine settings. We descriptively analyzed prospectively collected observational data from our four uterus recipients, all with MRKHS, their living donors, and the two newborns born to two recipients, including 1-year postnatal follow-ups. Analysis included only living-donor\/recipient pairs with completed donor\/recipient surgery. Two recipients, both requiring ovarian restimulation under immunosuppression after missed pregnancy loss in one case and no pregnancy in the other, each delivered a healthy boy by cesarean section. We conclude that parameters crucial to successful transplantation, pregnancy, and childbirth include careful selection of donor\/recipient pairs, donor organ quality, meticulous surgical technique, a multidisciplinary team approach, and comprehensive follow-up. Surgery duration and blood vessel selection await further optimization, as do the choice and duration of immunosuppression, which are crucial to timing the first embryo transfer. Data need to be collected in an international registry due to the low prevalence of MRKHS.<\/jats:p>","DOI":"10.3390\/jcm9082485","type":"journal-article","created":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T07:45:57Z","timestamp":1596440757000},"page":"2485","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":68,"title":["Living-Donor Uterus Transplantation: Pre-, Intra-, and Postoperative Parameters Relevant to Surgical Success, Pregnancy, and Obstetrics with Live Births"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5162-1542","authenticated-orcid":false,"given":"Sara Yvonne","family":"Brucker","sequence":"first","affiliation":[{"name":"T\u00fcbingen University Women\u2019s Hospital, Calwerstr. 7, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Strowitzki","sequence":"additional","affiliation":[{"name":"Department of Gynecological Endocrinology and Reproductive Medicine, Heidelberg University Women\u2019s Hospital, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florin-Andrei","family":"Taran","sequence":"additional","affiliation":[{"name":"Department of Gynecology, University Hospital Zurich, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Rall","sequence":"additional","affiliation":[{"name":"T\u00fcbingen University Women\u2019s Hospital, Calwerstr. 7, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorit","family":"Sch\u00f6ller","sequence":"additional","affiliation":[{"name":"T\u00fcbingen University Women\u2019s Hospital, Calwerstr. 7, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Hoopmann","sequence":"additional","affiliation":[{"name":"T\u00fcbingen University Women\u2019s Hospital, Calwerstr. 7, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Henes","sequence":"additional","affiliation":[{"name":"T\u00fcbingen University Women\u2019s Hospital, Calwerstr. 7, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Guthoff","sequence":"additional","affiliation":[{"name":"Section of Nephrology and Hypertension, Department of Diabetology, Endocrinology, and Nephrology, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Heyne","sequence":"additional","affiliation":[{"name":"Section of Nephrology and Hypertension, Department of Diabetology, Endocrinology, and Nephrology, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Zipfel","sequence":"additional","affiliation":[{"name":"Division of Psychosomatic Medicine and Psychotherapy, Department of Internal Medicine, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6569-921X","authenticated-orcid":false,"given":"Norbert","family":"Sch\u00e4ffeler","sequence":"additional","affiliation":[{"name":"Division of Psychosomatic Medicine and Psychotherapy, Department of Internal Medicine, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"B\u00f6sm\u00fcller","sequence":"additional","affiliation":[{"name":"Institute of Pathology and Neuropathology, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Falko","family":"Fend","sequence":"additional","affiliation":[{"name":"Institute of Pathology and Neuropathology, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rosenberger","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eckhard","family":"Heim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4957-4323","authenticated-orcid":false,"given":"Urban","family":"Wiesing","sequence":"additional","affiliation":[{"name":"Department of the Ethics and History of Medicine, T\u00fcbingen University Hospital, 72074 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2668-7325","authenticated-orcid":false,"given":"Konstantin","family":"Nikolaou","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University of T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Fleischer","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University of T\u00fcbingen, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamam","family":"Bakchoul","sequence":"additional","affiliation":[{"name":"Center for Transfusion Medicine, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1072-0066","authenticated-orcid":false,"given":"Christian F.","family":"Poets","sequence":"additional","affiliation":[{"name":"Department of Neonatology, T\u00fcbingen University Children\u2019s Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rangmar","family":"Goelz","sequence":"additional","affiliation":[{"name":"Department of Neonatology, T\u00fcbingen University Children\u2019s Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Wiechers","sequence":"additional","affiliation":[{"name":"Department of Neonatology, T\u00fcbingen University Children\u2019s Hospital, 72076 T\u00fcbingen, 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3622-4340","authenticated-orcid":false,"given":"Ernst","family":"Oberlechner","sequence":"additional","affiliation":[{"name":"T\u00fcbingen University Women\u2019s Hospital, Calwerstr. 7, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"H\u00fcbner","sequence":"additional","affiliation":[{"name":"T\u00fcbingen University Women\u2019s Hospital, Calwerstr. 7, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Abele","sequence":"additional","affiliation":[{"name":"T\u00fcbingen University Women\u2019s Hospital, Calwerstr. 7, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pernilla","family":"Dahm-K\u00e4hler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, 41345 G\u00f6teborg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niclas","family":"Kvarnstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Transplantation, Sahlgrenska Academy, University of Gothenburg, 41345 G\u00f6teborg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Br\u00e4nnstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, 41345 G\u00f6teborg, Sweden"},{"name":"Stockholm IVF, 12063 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio","family":"Nadalin","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, and Transplant Surgery, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diethelm","family":"Wallwiener","sequence":"additional","affiliation":[{"name":"T\u00fcbingen University Women\u2019s Hospital, Calwerstr. 7, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2301-4080","authenticated-orcid":false,"given":"Alfred","family":"K\u00f6nigsrainer","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, and Transplant Surgery, T\u00fcbingen University Hospital, 72076 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,8,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.fertnstert.2019.05.032","article-title":"Introduction: Uterus transplantation","volume":"112","year":"2019","journal-title":"Fertil. 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