*Purpose: Uterus transplantation (UTx) is the only treatment for women with uterine factor infertility (UFI). The majority of overall experience is from living donation. Little is known about live birth rates after embryo transfer and the long term outcomes of recipients with a uterus from deceased donors. We report here our updated experience with eight uterine transplanted patients from donors after brain death (DBD).

*Methods: Recipient inclusion criteria were absolute UFI, BMI<30 kg/m², ages 18 to 45 and at least six frozen embryos ready to be implanted. Child-bearing age donors with no uterine abnormalities were considered for donation, prioritizing those who had a previous term pregnancy.

*Results: Eight UTx from DBD have been performed since 2016. No injuries to donor’s life-saving organs were reported. Mean procurement time was 249 min (158-367), whereas mean operative time was 537 min (334-870). The average cold ischemia time was 300 min (110-434) and mean hospital stay was 11 (5-30) days. All recipients are alive and well. Two patients had graft losses occurring on postoperative day (POD) 12 and 6. Two patients delivered healthy neonates, two patients are pregnant (second trimester) and two patients are undergoing embryo transfers. Reinstitution of menstruation occurred on average on POD 22. Three patients became pregnant with the first attempt. Graft rejection was observed and successfully treated in two patients (Table 1). No severe hypertension or preeclampsia occurred. Creatinine value average was 0.81, 0.89 and 0.92 respectively at 3, 6 and 12 months after UTx.

*Conclusions: DBD procurement eliminates the burden of living donor comorbidities. Our findings indicate that UTx from DBD is a safe procedure with no renal impairment within 1-year follow-up. Although it is premature to state that DBD grafts are capable of establishing and carrying a pregnancy as a native organ, we do have encouraging preliminary evidence.

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