title: Live Donors of the Initial Observational Study of Uterus Transplantation-Psychological and Medical Follow-Up Until 1 Year After Surgery in the 9 Cases.
abstract: BACKGROUND
  The first prospective observational study of uterus transplantation was initiated in 2013 with live donation to 9 women with absolute uterine factor infertility. We explored the medical complications and psychosocial wellbeing of the donors during the first postoperative year.
  
  
  METHODS
  Complications were registered and graded according to the Clavien-Dindo (C-D) classification. Symptoms related to the surgery were registered. Data on length of hospital stay, sick leave, socioeconomic parameters, and life events were obtained. Psychological evaluations (Psychological General Well-Being, Dyadic Adjustment Scale, Hospital Anxiety and Depression Scale [HADS], SF-36) questionnaires focusing on quality of life, mood, and relationship, were conducted at inclusion and at 3, 6, and 12 months after uterus donation.
  
  
  RESULTS
  One major surgical complication (C-D IIIb) occurred. A ureteric-vaginal fistula developed 2 weeks after uterus procurement. The fistula was surgically repaired. Two self-reported and transient complications (C-D I) were noted (nocturia, meralgia paresthetica). Hospital stays of all donors were 6 days and median sick leave was 56 days (range, 14-132). At inclusion, median scores exceeded the normative values of the Swedish population in Psychological General Well-Being and Dyadic Adjustment Scale. HADS-Anxiety was detected preoperatively in 1 donor. Two donors exceeded 10-point declines in SF-36 summary scores and increased their HADS scores by 6 points during the observation period. All donors returned to their predonation levels of physical health.
  
  
  CONCLUSIONS
  The results support that it is feasible to retrieve a uterus safely from a live donor. Further studies are needed to better evaluate the method.
authors.affiliation: 1 Department of Transplantation, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. 2 Department of Obstetrics and Gynecology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. 3 Stockholm IVF, Stockholm, Sweden.
authors.forename: Niclas
authors.initials: N
authors.lastname: Kvarnström
authors.forename: Stina
authors.initials: S
authors.lastname: Järvholm
authors.forename: Liza
authors.initials: L
authors.lastname: Johannesson
authors.forename: Pernilla
authors.initials: P
authors.lastname: Dahm-Kähler
authors.forename: Michael
authors.initials: M
authors.lastname: Olausson
authors.forename: Mats
authors.initials: M
authors.lastname: Brännström
mesh_terms: D000328:Adult; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000523:psychology*; D007247:Infertility, Female / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D007902:Length of Stay; D008016:Life Change Events; D019520:Living Donors / Q000523:psychology*; D008603:Mental Health; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects / Q000379:methods / Q000523:psychology*; D011183:Postoperative Complications / Q000209:etiology / Q000523:psychology / Q000601:surgery; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D018582:Sick Leave; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome; D014599:Uterus / Q000473:pathology / Q000503:physiopathology / Q000637:transplantation*