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    Short term follow up results of the first human uterus transplantation from cadaver
    (Elsevier, 2012) Akar, M. Erman; Özkan, O.; Erdoğan, O.; Cincik, Mehmet; Mutlu, D.; Gunseren, F.; Pestereli, E.; Kocak, H.; Dinckan, A.; Hadimioglu, N.; Suleymanlar, G.
    Study Objective: To present the short term follow up results of the first human uterus transplantation from cadaver. Design: Case report. Setting: University hospital. Patients: A 19 year old female patient with complete mullerian agenesis presented with primary amenorrhea and inability to achieve intercourse. Intervention: Vaginal reconstruction with jejunum graft, in vitro fertilization and embryo vitrification procedures were performed. Following immunocompatibility tests for the transplantation, the patient was elected as the most suitable recipient for the uterus. The cadaver uterus was screened for the presence of any structural abnormalities and infections preoperatively. Uterus transplantation procedure consisted of revascularisation, reanastomoses of the right and left uterine arteries and veins(ishemia time for five hours), fixation of the uterovesical flap to the preexisting urinary bladder, suspension of the uterosacral ligament to sacrum. Measurements and Main Results: Early postoperative course was uneventful. Intraoperative and postoperative induction immunosuppressive therapy with thymoglobulin, tacrolimus, mycophenolate mofetil and prednisone was well tolerated. Maintanance immunosuppressive therapy with tacrolimus, mycophenolate mofetil and prednisone and prophylactic antiviral, antibacterial therapy was initiated. Bilateral uterine artery doppler ultrasonography showed good perfusion. We observed no signs of rejection and infection confirmed with laboratory and cytological findings. She has had six menstrual cycles since the operation. Conclusion: We have described restoration of menstrual cycles following uterus transplantation which might be a promising option to restore fertility in this selected group of patients.