First baby born to mother with uterus transplanted from deceased woman

Deceased donations could greatly improve fertility treatments for women with uterine problems.

  • The healthy baby girl was born to a 32-year-old woman in Brazil who received a uterus transplant from a deceased woman.
  • It marks the first successful transplant from a deceased donor. A handful of transplants from living donors have proven successful so far.
  • Deceased donations would greatly expand the pool of potential donors, considering it's relatively difficult to find living donors willing to undergo the procedure.

A baby born to a mother who received a uterus transplanted from a deceased woman is healthy nearly one year after her birth, marking the world's first case of producing a healthy child through the procedure.

The findings, reported by a team in Brazil, were published Tuesday in The Lancet.

Scientists worldwide have successfully conducted about a dozen uterine transplants from living donors so far, though there have been some complications and failed attempts. What's been unclear, however, is whether women with fertility problems might someday be able to receive transplants from the deceased. Ten previous attempts have failed or led to miscarriage.

The benefits of deceased transplants include the ability to extract more tissue from the vagina and blood vessel network, and they would also vastly expand the pool of potential donors, as living donors are often limited to family and friends of women in need.

The success of a recent case in Brazil shows promise for the future of deceased donations.

In 2016, a 32-year-old Brazilian woman born without a uterus received one through a transplant from a deceased 45-year-old mother who had died from a stroke. She was given anti-rejection drugs so her body would accept the transplant, and seven months later received a fertilized embryo through an implant.

In December 2017, she gave birth to a healthy baby girl by cesarean section at the Hospital das Clinicas, University of Sao Paulo School of Medicine. Doctors removed the uterus during the C-section because they want "to focus on helping more women have a single child rather than on one woman having more than one," as Dani Ejzenberg, the doctor at the University of Sao Paulo in Brazil who led the transplant team, told Scientific American.

A 'proof-of-concept' for treating uterine infertility

Infertility is caused by a wide range of factors. In the U.S., about 10 percent of women have trouble getting or staying pregnant, according to the Center for Disease Control and Prevention. The Brazilian woman in the recent study had a rare condition called Mayer-Rokitansky-Küster-Hauser syndrome (MRKH), in which a woman is born without a uterus altogether. (MRKH affects about 1 in every 5,000 women.)

Scientists, including one team at the Cleveland Clinic in the U.S., plan to continue conducting research on both living and deceased donations in order to improve fertility treatments for women with uterine problems.

The researchers said the Brazil case "establish[es] proof-of-concept for treating uterine infertility by transplantation from a deceased donor, opening a path to healthy pregnancy for all women with uterine factor infertility, without need of living donors or live donor surgery."

If that success can be replicated elsewhere, it could open up "a much wider potential donor population, applies lower costs and avoids live donors' surgical risks," Srdjan Saso, from Imperial College London, told the BBC.

But for now, it remains unclear whether deceased or living donations will be the more viable option in years to come.

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Kosovo land swap could end conflict - or restart war

Best case: redrawing borders leads to peace, prosperity and EU membership. But there's also a worst case

Image: SRF
Strange Maps
  • The Yugoslav Wars started in 1991, but never really ended
  • Kosovo and Serbia are still enemies, and they're getting worse
  • A proposed land swap could create peace - or reignite the conflict

The death of Old Yugoslavia

Image: public domain

United Yugoslavia on a CIA map from 1990.

Wars are harder to finish than to start. Take for instance the Yugoslav Wars, which raged through most of the 1990s.

The first shot was fired at 2.30 pm on June 27th, 1991, when an officer in the Yugoslav People's Army took aim at Slovenian separatists. When the YPA retreated on July 7th, Slovenia was the first of Yugoslavia's republics to have won its independence.

After the wars

Image: Ijanderson977, CC BY-SA 3.0 / Wikimedia Commons

Map of former Yugoslavia in 2008, when Kosovo declared its independence. The geopolitical situation remains the same today.

The Ten-Day War cost less than 100 casualties. The other wars – in Croatia, Bosnia and Kosovo (1) – lasted much longer and were a lot bloodier. By early 1999, when NATO had forced Serbia to concede defeat in Kosovo, close to 140,000 people had been killed and four million civilians displaced.

So when was the last shot fired? Perhaps it wasn't: it's debatable whether the Yugoslav Wars are actually over. That's because Kosovo is a special case. Although inhabited by an overwhelming ethnic-Albanian majority, Serbians are historically very attached to it. More importantly, from a legalistic point of view: Kosovo was never a separate republic within Yugoslavia but rather a (nominally) autonomous province within Serbia.

Kosovo divides the world

Image: public domain

In red: states that recognise the independence of Kosovo (most EU member states – with the notable exceptions of Spain, Greece, Romania and Slovakia; and the U.S., Japan, Turkey and Egypt, among many others). In blue: states that recognise Serbia's sovereignty over Kosovo (most notably Russia and China, but also other major countries such as India, Brazil, Mexico, South Africa and Iran).

The government of Serbia has made its peace and established diplomatic relations with all other former Yugoslav countries, but not with Kosovo. In Serbian eyes, Kosovo's declaration of independence in 2008 was a unilateral and therefore legally invalid change of state borders. Belgrade officially still considers Kosovo a 'renegade province', and it actually has a lot of international support for that position (2).

The irony is that on the longer term, both Kosovo and Serbia want the same thing: EU membership. Ironically, that wish could lead to Yugoslav reunification some years down the road – within the EU. Slovenia and Croatia have already joined, and all other ex-Yugoslav states would like to follow their example. Macedonia, Montenegro and Serbia have already submitted an official application. The EU considers Bosnia and Kosovo 'potential candidates'.

Kosovo is the main stumbling block on Serbia's road to EU membership. Even after the end of hostilities, skirmishes continued, between the ethnically Albanian majority and the ethnically Serbian minority within Kosovo, and vice versa in Serbian territories directly adjacent. Tensions are dormant at best. A renewed outbreak of armed conflict is not unthinkable.

Land for peace?

Image: BBC

Mitrovica isn't the only area majority-Serb area in Kosovo, but the others are enclaved and fear being abandoned in a land swap.

In fact, relations between Kosovo and Serbia have deteriorated spectacularly in the past few months. At the end of November, Kosovo was refused membership of Interpol, mainly on the insistence of Serbia. In retaliation, Kosovo imposed a 100% tariff on all imports from Serbia. After which Serbia's prime minister Ana Brnabic refused to exclude her country's "option" to intervene militarily in Kosovo. Upon which Kosovo's government decided to start setting up its own army – despite its prohibition to do so as one of the conditions of its continued NATO-protected independence.

The protracted death of Yugoslavia will be over only when this conflict is finally resolved. The best way to do that, politicians on both sides have suggested, is for the borders reflect the ethnic makeup of the frontier between Kosovo and Serbia.

The biggest and most obvious pieces of the puzzle are the Serbian-majority district of Mitrovica in northern Kosovo, and the Albanian-majority Presevo Valley, in southwestern Serbia. That land swap was suggested previous summer by Hashim Thaci and Aleksandar Vucic, presidents of Kosovo and Serbia respectively. Best-case scenario: that would eliminate the main obstacle to mutual recognition, joint EU membership and future prosperity.

If others can do it...

Image: Ruland Kolen

Belgium and the Netherlands recently adjusted out their common border to conform to the straightened Meuse River.

Sceptics and not a few locals warn that there also is a worst-case scenario: the swap could rekindle animosities and restart the war. A deal along those lines would almost certainly exclude six Serbian-majority municipalities enclaved deep within Kosovo. While Serbian Mitrovica, which borders Serbia proper, is home to some 40,000 inhabitants, those enclaves represent a further 80,000 ethnic Serbs – who fear being totally abandoned in a land swap, and eventually forced out of their homes.

Western powers, which sponsored Kosovar independence, are divided over the plan. U.S. officials back the idea, as do some within the EU. But the Germans are against – they are concerned about the plan's potential to fire up regional tensions rather than eliminate them.

In principle, countries consider their borders inviolate and unchanging, but land swaps are not unheard of. Quite recently, Belgium and the Netherlands exchanged territories so their joint border would again match up with the straightened course of the Meuse river (3). But those bits of land were tiny, and uninhabited. And as the past has amply shown, borders carry a lot more weight in the Balkans.

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The controversy around the Torah codes gets a new life.

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