Availability of deceased uterus donor: Is it a real case scenario in Spain?

Introduction

Absolute uterine factor infertility, historically considered untreatable, remained without proven effective treatment until 2014, when the first birth following uterus transplantation from a living donor occurred in Sweden. Since then, the procedure has been performed by other groups using living and deceased donors. Interest in deceased donors is increasing; however, global experience remains limited. The availability of potential deceased donors is unknown in many regions, and there is no clear consensus on inclusion criteria. Hence, the aim of this study is to determine the availability of potential deceased donors in our region and critically analyze actual inclusion criteria.

Material and Methods

A retrospective review of our organ procurement organization's database was conducted between January 1st 2015, and December 31st 2019, to identify potential deceased uterine donors. During this period, 201 women aged 18–50 were included in a multi-organ donation program after circulatory and brain death. Only brain death donors were considered, as described in the literature.

Results

After applying exclusion criteria, 14 and 48 potential deceased uterine donors were identified using standard and extended donor criteria. This corresponds to 1.8 and 6.3 deceased donors per million people throughout the entire period.

Conclusions

We believe the number of potential candidates remains low, and expanding inclusion criteria could increase organ availability, especially in those regions with emerging transplantation programs to establish cadaveric donor-based solutions.