Samsung Seoul Hospital Achieves Korea's First Successful Uterus Transplant

Uterus Transplant from Brain-Dead Donor to MRKH Syndrome Patient
Congenital Condition of Being Born Without a Uterus
Maintaining Normal Function for 10 Months Without Rejection
Preparing for Pregnancy via Artificial Insemination as the 'Final Goal'

Samsung Medical Center announced the country's first successful case of uterus transplantation.

Professor Jae-Bum Park (second from the left), Department of Transplant Surgery at Samsung Medical Center, is performing a transplant surgery.
[Photo by Samsung Medical Center]

Samsung Medical Center revealed on the 17th that its multidisciplinary uterus transplantation team transplanted a uterus from a brain-dead donor into a 35-year-old woman with MRKH (Mayer-Rokitansky-K?ster-Hauser) syndrome last January, and she has been maintaining a stable condition without any significant rejection for 10 months. Currently, the patient’s menstrual cycle is regular, indicating that the transplanted uterus is functioning normally, and she is reportedly preparing for pregnancy, the ultimate goal.

Professor Park Jaebeom of the Transplant Surgery Department at Samsung Medical Center summarized the news of the successful uterus transplantation at the Asian Transplantation Week 2023 international academic conference on transplantation held on the 17th.

MRKH syndrome is a congenital condition where the uterus and vagina are absent or underdeveloped. It is reported to occur in approximately one in every 5,000 women. This condition is often discovered incidentally at a hospital when a teenager does not begin menstruation. However, ovarian function is normal, so there is no hormonal impact, and ovulation is possible. Theoretically, pregnancy and childbirth are possible if a uterus is transplanted.

The patient who underwent uterus transplantation at Samsung Medical Center was also diagnosed with MRKH syndrome. After getting married and deciding to conceive, she visited Samsung Medical Center in 2021. At that time, the multidisciplinary uterus transplantation team at Samsung Medical Center had been formally organized and conducting related clinical research for nearly a year.

Funding Secured Through Donor Contributions... 'Hospital Playlist' Production Team Also Lent Support

The multidisciplinary uterine transplant team at Samsung Medical Center is having a meeting.
[Photo by Samsung Medical Center]

Encouraged by the patient’s strong determination, the uterus transplantation team accelerated their efforts. Since this was the first case of uterus transplantation in Korea, the team proceeded cautiously after obtaining legal advice, undergoing review by the Ministry of Health and Welfare, and completing Institutional Review Board (IRB) approval to ensure procedural legitimacy. They investigated overseas published papers and cases by specialty to establish theoretical foundations and planned every step from the actual transplantation surgery, survival strategies for the transplanted organ, to pregnancy and childbirth.

However, the cost of surgery was a major obstacle. In the domestic healthcare insurance system, new surgical attempts are conducted as 'clinical research,' and securing the substantial funding required for this was not easy, according to the transplantation team. At this time, donors who empathized with the patient’s maternal desire to nurture new life through uterus transplantation and the medical staff’s passion contributed through donations.

Donors included individuals and foundations who had previously donated to medical research, as well as the production team of the drama Hospital Playlist. The transplantation team explained that the Hospital Playlist production team’s donation was inspired by their connection with Professor Oh Sooyoung, an obstetrics and gynecology specialist on the uterus transplantation team who served as a role model for the character Professor Chae Songhwa and as a production advisor for the drama.

First Attempt Ended in Failure... Successful Retry After Six Months

The multidisciplinary uterine transplant team at Samsung Medical Center is talking with a patient.
[Photo by Samsung Medical Center]

The challenging uterus transplantation research hit a wall on the first attempt. In July 2022, the initial transplantation used a uterus from a living donor, but arterial and venous blood flow in the transplanted uterus was not smooth, requiring removal of the uterus two weeks after surgery.

The uterus transplantation team then awaited a uterus from a brain-dead donor. Fortunately, about six months after the first failure, in January, a brain-dead donor meeting the criteria was found, allowing the team to attempt a second transplantation surgery. The team thoroughly reviewed all procedures and meticulously prepared from the organ retrieval process of the donor. The hospital explained that performing delicate surgery to avoid damaging even the small, long blood vessels connected to the donor uterus was a critical factor for early success in uterus transplantation.

The result was successful. The patient experienced her first-ever menstruation 29 days after transplantation, signaling that the uterus had successfully settled in her body. Since the first menstruation, the patient has maintained a regular menstrual cycle. Biopsies conducted at 2, 4, and 6 weeks, as well as at 4 and 6 months post-transplantation, showed no signs of rejection. The transplantation team evaluated this as a sign that the transplanted uterus had fully taken root in the patient’s body.

Both the patient and the uterus transplantation team are now awaiting the arrival of a baby. Professors Lee Dongyoon and Kim Seongeun of the Obstetrics and Gynecology Department are inducing implantation in the transplanted uterus using embryos fertilized in advance with eggs retrieved from the patient’s ovaries and sperm from her husband. At the same time, they are checking all necessary conditions to ensure a safe and healthy childbirth after pregnancy.

Professor Park Jaebeom of the Transplant Surgery Department said, “Since this is the first case of uterus transplantation in Korea, we proceeded with utmost caution, feeling as if we were creating a ‘new path’ together with the patient through every step. The first failure was devastating, but we did not give up with the patient and overcame it, allowing the uterus to settle safely and enabling the patient to take the first step toward welcoming the baby she has longed for. We are grateful.”

Professor Lee Yooyoung of the Obstetrics and Gynecology Department said, “Thanks to the support not only from the patient and medical staff but also from many donors who generously supported the research, we have come this far. We will do our best until the end so that the efforts of the patient who made a difficult choice and the many people who cheered her on will not be in vain.”

Uterus Transplantation First Successful in Sweden in 2014... Samsung Medical Center’s Re-transplantation Attempt Is a 'World First'

Uterus Transplant Timeline.
[Image provided by Samsung Seoul Hospital]

Meanwhile, uterus transplantation was first attempted worldwide in Saudi Arabia in 2000. At that time, the patient had to have the transplanted uterus removed due to rejection 100 days after transplantation, resulting in failure to establish the organ. The first successful case emerged in Sweden in 2014, where both transplantation and childbirth were successful, drawing attention from the medical community.

As evidence has accumulated, successful transplantation cases have gradually increased. At the international uterus transplantation conference held in the United States last September, it was announced that there have been 109 successful uterus transplantation cases worldwide. Samsung Medical Center’s recent re-transplantation attempt is known to be the world’s first. Samsung Medical Center is preparing for uterus transplantation for another patient, building on this success.

This content was produced with the assistance of AI translation services.