Uterus Transplants?

A recent CNN article about womb transplants brings up a few interesting issues.

Approximately 1,800 heart-beating, but brain-dead, organ donors were identified through an existing donor network. The removal of several organs took place in about 150 of the donors. Nine had specifically consented to donate their uterus.

The uterus was removed without complications in eight donors. Tissue testing suggested that the organs were, in fact, suitable for transplantation.

The researchers point out that the transplant of organs that are not needed to preserve life raises ethical issues. Thus far, the only human uterine transplant that has been performed was "controversial and unsuccessful."

Nevertheless, they note that surgical techniques have improved and the successful retrieval of a usable human uterus brings the possibility of such transplants closer.

"Our hope," the team concludes, "is to eventually restore reproductive function through transplantation of a human uterus."

First of all, uterine transplants would require the administration of anti-rejection drugs, like all other transplants. Is it really wise to encourage women on anti-rejection drugs to become pregnant--no matter how badly they wish to have children?

Second, if you are going to harvest uteri for transplant, why not go to a larger source of living donors, rather than limited cadavers? Why not harvest the uteri of nuns and other healthy young women who have made a rational choice to forego childbirth? Assuming it is possible to handle rejection issues without drugs that may be dangerous to the fetus.

Third, why not learn to maintain the uterus and fetus ex corpore (out of body), and avoid the rejection issue altogether? There is a significant need for artificial wombs for gestating fetuses ex corpore, and what better to use than a living human uterus artificially maintained?

It is important for researchers to develop good means for long term "cold storage" of organs of all types. Vitrification and other preservation methods would help considerably with problems of organ transport to point of need. For donated uteri, workable vitrification would allow children to be born from a uterus long after the original donor had died.

It seems that both the researchers and the journalists reporting the story are thinking much too small, too short term. The genuine possibilities for expanding reproductive choice are much larger.