The baby of the first woman to receive a uterus transplant in Spain is born at the Hospital Clínic in Barcelona

In 1999, the University of Gothenburg started a project to give women without a uterus the possibility of being mothers.. In 2014 the first birth after transplantation from a living donor took place in Sweden. Now, in March 2023, Jesus has become the first baby born in our country after this intervention.. One more step in a long and complex path where science and technology seek to overcome insurmountable obstacles to fulfill the desire to have a child of their own.

This birth is part of the research project that the Hospital Clínic de Barcelona has launched to study the feasibility of the uterine transplant procedure from a living donor with the aim of validating the feasibility of this surgery. This is how in October 2020 the Catalan center performed the first uterus transplant in Spain, an intervention led by the head of the Gynecology Service, Francisco Carmona, and the head of the Urology and Kidney Transplant Service, Antonio Alcaraz.

“At the time, we already said that success was not having achieved a transplant of the uterus, but that it was necessary to achieve a successful pregnancy. Today we are happy because we can say that the long pilgrimage that we began in 2015 has had its first success,” Francisco Carmona himself explained during the presentation of the birth.

Little Jesus in the Neonatology ICU. FRANCISCO ÀVIA HOSPITAL CLINIC

Also present at the event was the Minister of Health of Catalonia, Manel Balcells, who highlighted the importance of the news. “This is a small miracle of science and it also fills us with pride for the public health system that we have, which is capable of carrying out extraordinary operations that end so well”. Josep Maria Campistol, general director of the Hospital Clínic, was equally satisfied. “We are a pioneering and innovative hospital where we like to break the mold, like this case right now. Without a doubt, we must congratulate both Francisco Carmona and Antonio Alcaraz, but without forgetting the interdisciplinary team of more than one hundred professionals who have made it possible”.

Premature birth but with good evolution

Tamara Franco was born with a strange pathology, Rokitansky syndrome, a congenital disorder of the female reproductive system that affects 1 in 5,000 women in the world who are born without a uterus or fallopian tubes.. She was the one who became the first woman with a uterus transplant in Spain in 2020. “After the success of the transplant, the complications did not end. After a first transfer that ended in an abortion, it was necessary to carry out a second one in September 2022, which was the one that ended with this birth,” added Carmona.

Moment of the cesarean section to which Tamara was subjected. FRANCISCO ÀVIA HOSPITAL CLINIC

The second pregnancy also had certain complications, derived mainly from the medication that the mother had to take for the transplant. This is how preeclampsia was detected, a common complication in transplanted mothers. For this reason, it was decided to wait until the 30th week of pregnancy to be able to perform a cesarean section.. “The operation that was carried out was completely standard, which speaks of the quality of the transplant. There were no complications and, since then, the baby has had a good evolution,” added Francesc Figueras, head of the Maternal-Fetal Medicine Service.

After the birth, the evolution has been verified, highlighting a good neuronal development, currently reaching, when precisely 40 weeks of pregnancy would be fulfilled, to exceed three kilos, which supposes a completely normal evolution.. “The only drawback is a slight bronchopulmonary dysplasia, which is moreover common in premature babies, but we hope that the oxygen that is administered intermittently can be withdrawn shortly,” added Carmona.

Steps of a very complex intervention

The transplant of the uterus is one of the most complex operations that exists, as Antonio Alcaraz highlighted during the press conference. “Its difficulty lies mainly in the fact that the non-pregnant uterus receives little blood, so the arteries that feed it are barely 2 millimeters and the veins are between 2 and 3, which requires very precise work”. For the operation, the surgeons used the support of a robot and it took eleven hours to extract the organ and another five to implant it.

After the complexity of the intervention, it should also be taken into account that after fulfilling their reproductive desire, the operated women must undergo a new intervention, a hysterectomy.. This is the case of Tamara, who has already undergone this operation, whose objective is to prevent the woman from having to follow treatment with immunosuppressants due to the transplant and since it is an organ that is not essential for life, it is not justifiable to prolong the situation.

Currently at the Hospital Clínic another uterus transplant has already been carried out successfully and two more are in process, with two more women being evaluated for the following phases. In total there have been 107 women who have requested to be part of the study, with the center having authorization to perform five transplants. “Although this study is focused on women with Rokitansky syndrome, this procedure could also be applicable to women with absolute uterine factor infertility, this means that either they do not have a uterus, it does not work or they have lost it, many possible indications,” added Carmona. Of these transplants, more than 50 babies have been born in the world to women who have received a uterus transplant, of which this is the first case in Spain.