Introduction: Uterus transplantation (UTx) may become another organ transplantation. There is very limited worldwide experience so far. The Czech uterus transplant trial started in 2015. The first UTx case we performed on 30th April 2016.

Method: The plan is for 20 uterus transplant procedures in total, of those 10 from life and 10 from deceased donors.

Sample cases: Case one: The live donor was the recipients mother, age of 53, history of two deliveries, underwent open hysterectomy via low midline incision, surgery took 5:23, the postoperative course was uneventful. The recipient with MRKG syndrome, age of 30, was transplanted in sequence, orthotropic transplantation via low midline incision took 3:29, uterine arteries and ovarian veins were anastomosed to iliac vessels. After protocol cervix biopsy on day 9 the patient was discharged from the hospital. Now the patient is already on Tacrolimus monotherapy, early next year we plan the first embryo transfer.

Sample case two: Deceased-donor uterus transplantation: The recipient did not have the compatible live donor, so was activated on deceased donor waiting list. On 31st August 2016 she received uterus from deceased donor. The postoperative course was same uneventful as in the live donor case. Both recipients are having regular follow up including cervix biopsies.

Results: The first transplant case was from live donor, performed on 30th April 2016. Second case in the study and first one from deceased donor followed shortly, graft thrombosed and removed on 7th postoperative day. Third case was from deceased donor, first ever in world from nulipara deceased donor, this case is fine, currently the only one out of four performed in world from deceased donor, which is still in place and awaiting emryostransfer. Last case was on 19th November, from live donor, doing well. Two more cases will follow shortly.

Conclusions: The UTx is still very novel method. From each case we keep learning. Uterus is the organ, where we cannot measure any function after the transplant. Also, visualizing the perfusion with Doppler ultrasound is not easy. Immunosuppression is based on induction, early steroid withdrawal, MMF withdrawal at 6 months and long-term Tacrolimus monotherapy maintenance.

CITATION INFORMATION: Fronek J, Chmel R, Janousek L, Novackova M, Matecha J, Olausson M. Living and Deceased Donor Uterus Transplantation – The 2-Arm Czech Uterus Transplant Trial: The First Year Report with Four Cases Done so Far. Am J Transplant. 2017;17 (suppl 3).

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