Living donor uterus transplant research project in Singapore: Progress of the first case

Abstract Introduction To report the progress of the human living uterus transplant research project in Singapore. Material and Methods The uterus transplant research project began in 2012 with a collaboration between the Swedish and Singapore teams. Ethics approval was obtained from the SingHealth C...

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Main Authors: Hak Koon Tan, Terence Y. S. Kee, Bien Keem Tan, Pernilla Dahm‐Kähler, Niclas Kvarnström, Ravinchandran Nadarajah, Khong Yik Chew, Ban Hock Tan, Tew Hong Ho, Lay Kok Tan, Yin Ru Tan, Sobhana Thangaraju, Loong Tat Wong, John S. E. Lee, Leslie E. C. Lim, Shing Lih Wong, Lay Guat Ng, Yan Mee Law, Crystal Lim, Prema Raj Jeyaraj, Ruban Poopalingam, Mats Brännström
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.15048
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author Hak Koon Tan
Terence Y. S. Kee
Bien Keem Tan
Pernilla Dahm‐Kähler
Niclas Kvarnström
Ravinchandran Nadarajah
Khong Yik Chew
Ban Hock Tan
Tew Hong Ho
Lay Kok Tan
Yin Ru Tan
Sobhana Thangaraju
Loong Tat Wong
John S. E. Lee
Leslie E. C. Lim
Shing Lih Wong
Lay Guat Ng
Yan Mee Law
Crystal Lim
Prema Raj Jeyaraj
Ruban Poopalingam
Mats Brännström
author_facet Hak Koon Tan
Terence Y. S. Kee
Bien Keem Tan
Pernilla Dahm‐Kähler
Niclas Kvarnström
Ravinchandran Nadarajah
Khong Yik Chew
Ban Hock Tan
Tew Hong Ho
Lay Kok Tan
Yin Ru Tan
Sobhana Thangaraju
Loong Tat Wong
John S. E. Lee
Leslie E. C. Lim
Shing Lih Wong
Lay Guat Ng
Yan Mee Law
Crystal Lim
Prema Raj Jeyaraj
Ruban Poopalingam
Mats Brännström
author_sort Hak Koon Tan
collection DOAJ
description Abstract Introduction To report the progress of the human living uterus transplant research project in Singapore. Material and Methods The uterus transplant research project began in 2012 with a collaboration between the Swedish and Singapore teams. Ethics approval was obtained from the SingHealth Centralised Institutional Review Board, the SingHealth Transplant and the Singapore General Hospital Biomedical Ethics Committee to perform 5 uterus transplant procedures in a collaborative multi‐site research study at the Singapore General Hospital. Regulatory approval was obtained from the Ministry of Health, Singapore. A suitable recipient–donor pair was identified. The living donor was the perimenopausal mother‐in‐law of the recipient who had Mayer–Rokitansky–Kuster–Hauser syndrome. They underwent the requisite matching process as well as robust medical, psychiatric and psychosocial assessments. The recipient then underwent in vitro fertilization (IVF) treatment resulting in 6 frozen blastocysts. Preparations were made for the transplant surgery on 25 November 2023 in Singapore General Hospital, aided by the 3 Uterus transplant experts from the Swedish Team, for whom temporary registration was granted by the Singapore Medical Council. Results This first uterus transplant procedure involved an operative time of 10 h and 30 min for the donor. The synchronized recipient surgery lasted 6 h and 20 min. Surgery was by midline laparotomy in both the living donor and recipient. The total warm ischemic time of the graft was 45 min, and the cold ischemic time was 1 h 45 min (total ischemic time 2 h 30 min). The patient's first menstruation occurred 38 days after the uterus transplant procedure. Cytomegalovirus infection was detected 6 weeks postoperatively for which she was aggressively treated. Serial cervical biopsies showed no rejection and Doppler ultrasound of the transplanted uterus showed good uterine blood flow. Conclusions To date the Living Donor Uterus Transplant Research Project in Singapore has progressed with a uterus transplant surgery involving a living donor performed by a multidisciplinary team. The recipient had a menstrual period 38 days postoperatively. Further study of the outcomes from this procedure will inform the safety and efficacy of uterus transplant in the Singapore context.
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spelling doaj-art-a7e628ddb3064eb0951521e269ea91d22025-08-20T03:31:00ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122025-03-01104354855810.1111/aogs.15048Living donor uterus transplant research project in Singapore: Progress of the first caseHak Koon Tan0Terence Y. S. Kee1Bien Keem Tan2Pernilla Dahm‐Kähler3Niclas Kvarnström4Ravinchandran Nadarajah5Khong Yik Chew6Ban Hock Tan7Tew Hong Ho8Lay Kok Tan9Yin Ru Tan10Sobhana Thangaraju11Loong Tat Wong12John S. E. Lee13Leslie E. C. Lim14Shing Lih Wong15Lay Guat Ng16Yan Mee Law17Crystal Lim18Prema Raj Jeyaraj19Ruban Poopalingam20Mats Brännström21Department of Obstetrics and Gynaecology Singapore General Hospital Singapore SingaporeDepartment of Renal Medicine Singapore General Hospital Singapore SingaporeDepartment of Plastic, Reconstructive & Aesthetic Surgery Singapore General Hospital Singapore SingaporeSahlgrenska Academy University of Gothenburg Gothenburg SwedenSahlgrenska Academy University of Gothenburg Gothenburg SwedenDepartment of Obstetrics and Gynaecology Singapore General Hospital Singapore SingaporeDepartment of Plastic, Reconstructive & Aesthetic Surgery Singapore General Hospital Singapore SingaporeDepartment of Infectious Diseases Singapore General Hospital Singapore SingaporeDepartment of Obstetrics and Gynaecology Singapore General Hospital Singapore SingaporeDepartment of Obstetrics and Gynaecology Singapore General Hospital Singapore SingaporeDepartment of Obstetrics and Gynaecology Singapore General Hospital Singapore SingaporeDepartment of Renal Medicine Singapore General Hospital Singapore SingaporeDepartment of Anaesthesiology Singapore General Hospital Singapore SingaporeDepartment of Anaesthesiology Singapore General Hospital Singapore SingaporeDepartment of Psychiatry Singapore General Hospital Singapore SingaporeDepartment of Pathology Singapore General Hospital Singapore SingaporeDepartment of Urology Singapore General Hospital Singapore SingaporeDepartment of Diagnostic Radiology Singapore General Hospital Singapore SingaporeDepartment of Medical Social Services Singapore General Hospital Singapore SingaporeDepartment of Hepatobiliary and Transplant Surgery Singapore General Hospital Singapore SingaporeDepartment of Anaesthesiology Singapore General Hospital Singapore SingaporeSahlgrenska Academy University of Gothenburg Gothenburg SwedenAbstract Introduction To report the progress of the human living uterus transplant research project in Singapore. Material and Methods The uterus transplant research project began in 2012 with a collaboration between the Swedish and Singapore teams. Ethics approval was obtained from the SingHealth Centralised Institutional Review Board, the SingHealth Transplant and the Singapore General Hospital Biomedical Ethics Committee to perform 5 uterus transplant procedures in a collaborative multi‐site research study at the Singapore General Hospital. Regulatory approval was obtained from the Ministry of Health, Singapore. A suitable recipient–donor pair was identified. The living donor was the perimenopausal mother‐in‐law of the recipient who had Mayer–Rokitansky–Kuster–Hauser syndrome. They underwent the requisite matching process as well as robust medical, psychiatric and psychosocial assessments. The recipient then underwent in vitro fertilization (IVF) treatment resulting in 6 frozen blastocysts. Preparations were made for the transplant surgery on 25 November 2023 in Singapore General Hospital, aided by the 3 Uterus transplant experts from the Swedish Team, for whom temporary registration was granted by the Singapore Medical Council. Results This first uterus transplant procedure involved an operative time of 10 h and 30 min for the donor. The synchronized recipient surgery lasted 6 h and 20 min. Surgery was by midline laparotomy in both the living donor and recipient. The total warm ischemic time of the graft was 45 min, and the cold ischemic time was 1 h 45 min (total ischemic time 2 h 30 min). The patient's first menstruation occurred 38 days after the uterus transplant procedure. Cytomegalovirus infection was detected 6 weeks postoperatively for which she was aggressively treated. Serial cervical biopsies showed no rejection and Doppler ultrasound of the transplanted uterus showed good uterine blood flow. Conclusions To date the Living Donor Uterus Transplant Research Project in Singapore has progressed with a uterus transplant surgery involving a living donor performed by a multidisciplinary team. The recipient had a menstrual period 38 days postoperatively. Further study of the outcomes from this procedure will inform the safety and efficacy of uterus transplant in the Singapore context.https://doi.org/10.1111/aogs.15048absolute uterine factor infertilityliving transplantmultidisciplinary teamSingaporeuterus transplantation
spellingShingle Hak Koon Tan
Terence Y. S. Kee
Bien Keem Tan
Pernilla Dahm‐Kähler
Niclas Kvarnström
Ravinchandran Nadarajah
Khong Yik Chew
Ban Hock Tan
Tew Hong Ho
Lay Kok Tan
Yin Ru Tan
Sobhana Thangaraju
Loong Tat Wong
John S. E. Lee
Leslie E. C. Lim
Shing Lih Wong
Lay Guat Ng
Yan Mee Law
Crystal Lim
Prema Raj Jeyaraj
Ruban Poopalingam
Mats Brännström
Living donor uterus transplant research project in Singapore: Progress of the first case
Acta Obstetricia et Gynecologica Scandinavica
absolute uterine factor infertility
living transplant
multidisciplinary team
Singapore
uterus transplantation
title Living donor uterus transplant research project in Singapore: Progress of the first case
title_full Living donor uterus transplant research project in Singapore: Progress of the first case
title_fullStr Living donor uterus transplant research project in Singapore: Progress of the first case
title_full_unstemmed Living donor uterus transplant research project in Singapore: Progress of the first case
title_short Living donor uterus transplant research project in Singapore: Progress of the first case
title_sort living donor uterus transplant research project in singapore progress of the first case
topic absolute uterine factor infertility
living transplant
multidisciplinary team
Singapore
uterus transplantation
url https://doi.org/10.1111/aogs.15048
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