Doctors at the Cleveland Clinic said that a 26-year-old woman is recovering well after receiving a uterus transplant late last month.
Prayed to God
The experimental surgery is part of a new frontier in transplantation that, if it works, might be an alternative for some of the thousands of women unable to have children because they were born without a uterus or lost it to disease.
The recipient of the nation's first uterus transplant says that she prayed for years to be able to bear a child, and is grateful to the deceased donor's family and the surgeons who've given her that chance.
The woman, identified only as Lindsey to protect her family's privacy, appeared briefly at a news conference with her husband. She said she already is a mother to three "beautiful little boys" adopted through foster care and that she was told when she was 16 that she wouldn't be able to bear children.
Read: Woman with womb transplant has healthy baby
"From that moment on, I've prayed that God would allow me the opportunity to experience pregnancy," she said. "And here we are today, at the beginning of that journey."
The woman must wait at least a year to ensure the new uterus is healthy enough to try getting pregnant through in vitro fertilisation, using embryos frozen ahead of the operation. To monitor the transplant, she will undergo monthly examinations.
Other countries have tried womb transplants. Sweden reported the first successful birth in 2014, with a total of five healthy babies from nine transplants so far. The transplant team at the Cleveland Clinic, which has been exploring the possibility of performing uterus transplants for 10 years, trained with the Swedish surgeons.
The hospital has screened more than 250 women to identify 10 who qualify for the clinical trial, those lacking a functional uterus but with healthy ovaries that produce eggs. They must understand the risks – complications from abdominal surgery, plus the possibility that the transplant will fail – and that it's experimental.
Read: Womb transplant, hope for women
"We must remember a uterine transplant is not just about a surgery and about moving a uterus from here to there. It's about having a healthy baby," said Cleveland Clinic surgeon Dr Rebecca Flyckt.
One concern, both medically and ethically, is the effect that necessary anti-rejection drugs have on a developing foetus, the doctors said. Dr Andreas Tzakis, a transplant surgeon who is leading the study, said many women who've had kidney transplants have delivered healthy babies while taking anti-rejection drugs.
Births will be by Caesarean section. The transplanted uterus will be removed after the woman has had one or two babies so that she won't need those drugs the rest of her life.
The United Network for Organ Sharing, which oversees U.S. transplants, said Baylor University in Dallas and Boston's Brigham and Women's Hospital have also been approved for uterine transplants.
Read: Mother with womb transplant says risk paid off
A uterus donation requires a separate consent from a deceased donor's family, like donations for other new procedures such as hand and face transplants, said UNOS chief medical officer Dr David Klassen.
Sweden has the only births
The donor for the Cleveland Clinic transplant was described as a healthy woman in her 30s who'd had children and had died suddenly. Sweden has used living donors for transplants there, but the Cleveland Clinic trial, to avoid any risk to a donor, decided to start with donors who have died.
The Cleveland Clinic patient, Lindsey, said she was grateful to that donor's family. "They have provided me with a gift that I will never be able to repay."
Dr Mats Brannstrom of Sahlgrenska University Hospital at the University of Gothenburg said the Cleveland surgery marked the 13th transplant worldwide. According to Brannstrom, Saudi Arabia and Turkey previously reported attempts and China performed one in November, but Sweden so far has had the only births.
Wombs for cash in tough times
Woman gives birth with re-implanted ovary tissue
Nine Swedish women receive transplanted wombs