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<datestamp>2017-12-21</datestamp>
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<publisher>HAL CCSD</publisher>
<title lang=en>Which Donor for Uterus Transplants: Brain-Dead Donor or Living Donor? A Systematic Review</title>
<creator>Lavoué, Vincent</creator>
<creator>Vigneau, Cécile</creator>
<creator>Duros, Solène</creator>
<creator>Boudjema, Karim</creator>
<creator>Lévêque, Jean</creator>
<creator>Piver, Pascal</creator>
<creator>Aubard, Yves</creator>
<creator>Gauthier, Tristan</creator>
<contributor>Service de Gynécologie et Obstétrique [Rennes] ; Université de Rennes 1 (UR1) - CHU Pontchaillou [Rennes] - Hôpital Sud</contributor>
<contributor>Chemistry, Oncogenesis, Stress and Signaling (COSS) ; Université de Rennes 1 (UR1) - CRLCC Eugène Marquis (CRLCC) - Institut National de la Santé et de la Recherche Médicale (INSERM)</contributor>
<contributor>CHU Pontchaillou [Rennes]</contributor>
<contributor>Institut de recherche, santé, environnement et travail [Rennes] (Irset) ; Université d'Angers (UA) - Université des Antilles et de la Guyane (UAG) - Université de Rennes 1 (UR1) - École des Hautes Études en Santé Publique [EHESP] (EHESP) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )</contributor>
<contributor>Service de Chirurgie Hépatobiliaire et Digestive ; Université de Rennes 1 (UR1) - Hôpital Pontchaillou - CHU Pontchaillou [Rennes]</contributor>
<contributor>Centre d'Investigation Clinique [Rennes] (CIC) ; Université de Rennes 1 (UR1) - Hôpital Pontchaillou - Institut National de la Santé et de la Recherche Médicale (INSERM)</contributor>
<contributor>Foie, métabolismes et cancer ; Université de Rennes 1 (UR1) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )</contributor>
<contributor>Service de Gynécologie-Obstétrique [CHU Limoges] ; CHU Limoges</contributor>
<description>International audience</description>
<source>Transplantation</source>
<identifier>hal-01447062</identifier>
<identifier>https://hal-univ-rennes1.archives-ouvertes.fr/hal-01447062</identifier>
<source>https://hal-univ-rennes1.archives-ouvertes.fr/hal-01447062</source>
<source>Transplantation, 2017, 101 (2), pp.267-273. 〈10.1097/TP.0000000000001481〉</source>
<identifier>DOI : 10.1097/TP.0000000000001481</identifier>
<relation>info:eu-repo/semantics/altIdentifier/doi/10.1097/TP.0000000000001481</relation>
<identifier>PUBMED : 27607535</identifier>
<relation>info:eu-repo/semantics/altIdentifier/pmid/27607535</relation>
<language>en</language>
<subject>[SDV.CAN] Life Sciences [q-bio]/Cancer</subject>
<subject>[SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology</subject>
<type>info:eu-repo/semantics/article</type>
<type>Journal articles</type>
<description lang=en>BACKGROUND: The aim of this systematic review was to evaluate and compare the pros and cons of using living donors or brain-dead donors in uterus transplantation programs, 2 years after the first worldwide live birth after uterus transplantation. METHODS: The Medline database and the Central Cochrane Library were used to locate uterine transplantation studies carried out in human or nonhuman primates. All types of articles (case reports, original studies, meta-analyses, reviews) in English or French were considered for inclusion. RESULTS: Overall, 92 articles were screened and 44 were retained for review. Proof of concept for human uterine transplantation was demonstrated in 2014 with a living donor. Compared with a brain-dead donor strategy, a living donor strategy offers greater possibilities for planning surgery and also decreases cold ischemia time, potentially translating into a higher success rate. However, this approach poses ethical problems, given that the donor is exposed to surgery risks but does not derive any direct benefit. A brain-dead donor strategy is more acceptable from an ethical viewpoint, but its feasibility is currently unproven, potentially owing to a lack of compatible donors, and is associated with a longer cold ischemia time and a potentially higher rejection rate. CONCLUSIONS: The systematic review demonstrates that uterine transplantation is a major surgical innovation for the treatment of absolute uterine factor infertility. Living and brain-dead donor strategies are not mutually exclusive and, in view of the current scarcity of uterine grafts and the anticipated future rise in demand, both will probably be necessary.</description>
<date>2017</date>
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