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New Advances in Uterus and Ovarian Transplantation: 2nd Edition
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New Advances in Uterus and Ovarian Transplantation: 2nd Edition

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 20 November 2025 | Viewed by 1479

Special Issue Editor

Dr. Elliott G. Richards

E-Mail Website
Guest Editor
Obstetrics and Gynecology and Women’s Health Institute, Cleveland Clinic, Cleveland, OH 44195, USA
Interests: uterus transplantation; gynaecological surgery; endometriosis; IVF; fibroids; reproductive medicine; laparoscopic surgery; assisted reproductive technology; reproductive endocrinology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

I am pleased to invite you to contribute to the Special Issue "New Advances in Uterus and Ovarian Transplantation: 2nd Edition". This is a new edition; we published five papers in the first volume. For more details, please visit https://www.mdpi.com/journal/jcm/special_issues/F718X72935.

As the Guest Editor of this Special Issue, I invite you to submit your novel research and reviews pertaining to uterus and ovary transplantation. In this Special Issue, we will seek to explore the next questions in the field, including, but not limited to, the following: tissue bioengineering; challenging cases in reproductive transplants either due to oncologic technical; new techniques and surgical innovation; expanding access to reproductive transplants; and calls to action for research needed in these innovative fields. As a journal of general scientific interest not solely restricted to transplant surgery or reproductive medicine, this Special Issue in the Journal of Clinical Medicine will bring together a multidisciplinary group of authors to highlight what is next on the horizon. Your contributions are greatly needed.

Dr. Elliott G. Richards
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • uterus transplantation
  • gynaecological surgery
  • endometriosis
  • IVF
  • fibroids
  • reproductive medicine
  • laparoscopic surgery
  • assisted reproductive technology
  • reproductive endocrinology

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Published Papers (2 papers)

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Research

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11 pages, 1538 KB  
Article
Feasibility of Near-Infrared Spectroscopy for Monitoring Tissue Oxygenation During Uterus Transplantation and Hysterectomy
by Jeremy Applebaum, Dan Zhao, Nawar Latif and Kathleen O’Neill
J. Clin. Med. 2025, 14(14), 4832; https://doi.org/10.3390/jcm14144832 - 8 Jul 2025
Viewed by 383
Abstract
Background/Objective: Thrombosis is the leading cause of graft failure and immediate hysterectomy following uterus transplantation (UTx). Currently, there is no standardized method for real-time assessment of UTx graft perfusion. This feasibility study aims to evaluate the utility of a near-infrared spectroscopy (NIRS) probe [...] Read more.
Background/Objective: Thrombosis is the leading cause of graft failure and immediate hysterectomy following uterus transplantation (UTx). Currently, there is no standardized method for real-time assessment of UTx graft perfusion. This feasibility study aims to evaluate the utility of a near-infrared spectroscopy (NIRS) probe for non-invasive monitoring of local cervical tissue oxygenation (StO2) during UTx. As proof-of-concept for the NIRS device, cervical StO2 was also measured during non-donor hysterectomy and bilateral salpingo-oophorectomy to establish its capacity to reflect perfusion changes corresponding to vascular ligation. Methods: The ViOptix T. Ox Tissue Oximeter NIRS probe was attached to four uterine cervices during hysterectomy procedures and three separate donor cervices during UTx. Real-time StO2 measurements were recorded at critical surgical steps: baseline, ovarian vessel ligation, contralateral ovarian vessel ligation, uterine vessel ligation, contralateral uterine vessel ligation, and colpotomy for hysterectomy; donor internal iliac vein anastomosis to recipient external iliac vein, donor internal iliac artery anastomosis to recipient external iliac artery, contralateral donor internal iliac vein anastomosis to recipient external iliac vein, contralateral donor internal iliac artery anastomosis to recipient external iliac artery, and donor and recipient vagina anastomosis for UTx. Results: During hysterectomy, average StO2 levels sequentially decreased: 70.2% (baseline), 56.7% (ovarian vessel ligation), 62.1% (contralateral ovarian vessel ligation), 50.5% (uterine vessel ligation), 35.8% (contralateral uterine vessel ligation), and 8.5% (colpotomy). Conversely, during UTx, StO2 progressive increased with each anastomosis: 8.9% (internal iliac vein- external iliac vein), 27.9% (internal iliac artery-external iliac artery), 56.9% (contralateral internal iliac vein-contralateral external iliac vein), 65.9% (contralateral internal iliac artery-contralateral external iliac artery), and 65.2% (vaginal anastomosis). Conclusions: The inverse correlation between StO2 and vascular ligation during hysterectomy and the progressive rise in StO2 during UTx suggests that cervical tissue oximetry may serve as a non-invasive modality for monitoring uterine graft perfusion. Further studies are warranted to determine whether these devices complement current assessments of uterine graft viability and salvage thrombosed grafts. Full article
(This article belongs to the Special Issue New Advances in Uterus and Ovarian Transplantation: 2nd Edition)
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Review

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10 pages, 234 KB  
Review
Pregnancy and Delivery After Solid Organ and Uterus Transplantation: A Review
by Iori Kisu, Mitsutoshi Yamada, Satoru Ikenoue and Wataru Yamagami
J. Clin. Med. 2025, 14(14), 5138; https://doi.org/10.3390/jcm14145138 - 19 Jul 2025
Viewed by 755
Abstract
In recent years, advances in organ transplantation medicine have led to an increase in pregnancies and births following transplantation. Pregnancy after organ transplantation is considered high-risk, and its impact on both the recipient and the child must be carefully evaluated. In this review, [...] Read more.
In recent years, advances in organ transplantation medicine have led to an increase in pregnancies and births following transplantation. Pregnancy after organ transplantation is considered high-risk, and its impact on both the recipient and the child must be carefully evaluated. In this review, we summarize the current landscape of pregnancy and childbirth after organ transplantation, with a particular focus on uterus transplantation (UTx). Traditionally, organ transplants have involved vital organs; however, UTx, developed for women with absolute uterine factor infertility, represents a novel approach. Although the number of births following UTx remains limited, it is expected to grow due to the international expansion of this procedure. Importantly, the concept of pregnancy and delivery following UTx is fundamentally different from that of other organ transplants. UTx is a life-enhancing, non-vital, and temporary transplant uniquely intended to enable the creation of new life. Pregnancy after UTx carries specific risks such as a higher incidence of miscarriage, preterm birth, hypertensive disorders of pregnancy, and gestational diabetes. All deliveries are performed via cesarean section, and conception is typically allowed after a relatively short period following transplantation, given the temporary nature of the graft and the goal to minimize recipient burden, with generally good neonatal outcomes. As pregnancies after both solid organ transplantation and UTx continue to rise worldwide, the development of standardized, organ-specific perinatal management strategies, particularly for UTx, is essential. Multidisciplinary collaboration will be critical to supporting these high-risk pregnancies and ensuring the best possible maternal and neonatal outcomes. Full article
(This article belongs to the Special Issue New Advances in Uterus and Ovarian Transplantation: 2nd Edition)
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