Wednesday , September 28 2022

The birth baby was born after the chain postpartum baby


Transplant baby born Source: AP – Credit: Dr. Wellington Andraus

It happened in Brazil. On December 15, 2017, a baby was born at 2,550 pounds and was born in perfect health. Three days later, the mother and daughter were home. Until now, it is unusual, except for a decisive event: the first birth of the world is the cough obtained from a transplant from a donor's uterus and after transplanting it to the uterus in Latin America for the first time.

She was a 32-year-old woman who produced ovaries and eggs, but the Mayer-Rokitansky-Küster-Hauser Syndrome, with 4,500 women causing congenital disorders in the uterus, received another 45 organs. one dead as a result of a stroke. Donated to menopause seven years earlier, she delivered her uterus. The treatment took place in September 2016 but has recently been published in the medical journal

"From medical and scientific point of view: brilliant, technologically sensible," says Dr. Mario Sebastiani, an obstetrician and member of the Italian Hospital Ethics Committee. "When you have a transplant in the uterus, you need anastomosis. [conexión de los vasos sanguineos] Recipients with donated organ; the organ is very small [pesa 225 gramos] And the difficulties stand out. But the procedure is also a complex ethical point, for the approval of the organ, it can affect women's risk of surgery and immunosuppression, because they endangered individual infections, without threatening death (as in this case). Other transplants, except cornea and kidney) and alternatives. "

The transplant required 10 hours and a half of surgery to prevent high doses of immunosuppressants. Six weeks later, the recipient started menstruation. During the seven months after the ingestion, the doctors set up an embryo that had their son's son and his partner's son. After delivering, the doctors have taken a transplanted uterus to recover the immune system. In his work, according to the medical staff at the Hospital of the San Pablo Hospital, this achievement will facilitate "broad adoption" of this intervention and suggests that heterosexual women with chronic illnesses would not help, but rather cardiovascular disease, organ infections or cancer.

This operation, for the moment, is experimental. The group with the largest number of these operations is the Gynecologist Mats Brännström, and in 2013 he reported the birth of the first child among the living arteries. From the age of 39, eleven healthy babies were born, but in this way, donors generally are mothers, sisters or recipients, and the organs are very limited.

"Through a chronic operator, it does not endanger the lender, and it also reduces costs, because it prevents female hospitalization," said Dani Ejzenberg, head of the University of San Pablo. research So far, 10 transplants have attempted this way, but without success.

However, optimism is not shared for everyone. "From an ethical point of view it is a very technical doubtful achievement," said Beatriz Domínguez-Gil, Director of National Organic Transplantation, in El País newspaper in Spain. In 2016, the organization's ethics committee analyzed and dismissed these procedures, as they were more likely to receive benefits. "In the case of women born without uterus, when this is done, women prevent the right to maternity, but in our opinion, it is important to respect the principle of instability [no hacer daño] and the proper use of public resources. "In Argentina, this type of intervention has not yet been recorded, although the Italian Hospital has evaluated the possibility of launching a program.

"I was in Göteborg where the Uterus Transplants Society was created, there were 50 or 60 physicians from all over the world," says young gynecologist Victorio Viglierchio, a hospital in Buenos Aires to learn about this technique.

According to specialist, the protocol for making this type of intervention is not easy. It is necessary to identify the candidates, in general, for women with genetic changes and find them as possible. Then you need to stimulate the ovaries, remove oocytes, freeze them, create embryos and eventually make biopsies to study cosmos. In the case of donation, those who do not have a previous particle in the case of birth and with endometrial biopsy are often frequent in transplantation to the uterus. "The body of the cadaver prevents some difficulties, but it requires a very oxidative technique, a multidisciplinary group works by surgeons, gynecologists and immunologists," says Viglierchio, "when it comes to working with the life partner, the advantage is that there is more Histoconpresibility and a softer immunosuppressant patient , in both cases, subsequent pregnancy is at high risk. "

If one of these conditions is considered, those procedures that are considered to be beneficial in a large number of patients and that deny the transplantation do not provide treatment for patients with severe illness. In this group, it is envisaged that this technique will be extended to women with problems of induction of the uterus, oncological problems, good tumors or infections caused by women, and so far the only alternatives were surrogates or adoptions. In the country there is no law on subrogation, but in this case there is no jurisprudence.

"Europe is already talking about transplants that can be applied to uterine transplants," says Viglierchio, "it is technically possible that men have the same female pelvis as the same".

Others ask that it is a medical need or a luxury. "The uterus transplant, like everyone else, is not for the patient's life to be saved," said Viglierchio. "The goal is to kill deadness and morbidity to overcome the ultimate goal that can sometimes be overcome. Subrogated mood. Therefore, it is often argued that it is achieved at any cost for motherhood, but for me all pros and cons."

"Could it be said, is there no alternative?", Sebastian reflects that "because the woman is under a very dangerous event, to be subrogation or adoption." The principle of bioethics is justice. The distribution of justice The money is fixed and therefore, in these cases, it requires a large amount of resources, apart from other urgent problems in public health? & # 39; Gestar & # 39; it would not be 'motherhood'. In things that generate success: in medicine, in human resources, peripheries are explored to stimulate creativity, to think, to take more limits. "

On the other hand, Ramfer Quintana Iferren's director for medical reproduction is obliged to take into account legal and social aspects. "It is possible, but it involves risks," he says, "in the case of subrogation, they have been made here, but there are fewer than a dozen born from this method."

Incucai authorities know that there is currently no group of transplants in Argentina. It is not included in current technical practices, and should, if necessary, be in the framework of a research protocol. Two years ago, the Gynecology and the Obstetrician Association of Argentina and the Malaysian Foundation of the Favaloro Foundation, the Australian Hospital and the Surgeon of the Italian Hospital signed a protocol to develop a protocol, but it is still underway.

Source link