Dear Colleagues,

Uterus transplantation (UTx) is now a real opportunity for women affected by absolute uterine factor infertility (UFI) to get pregnancy. UFI, either congenital or acquired, affects 1 in 500 fertile-aged women. The most frequent congenital reason for UFI is MRKH syndrome. 

UTx represents a special event in the field of transplantation: it’s a temporary transplant, non-lifesaving and involving several parts. There are two valid options for donation: living or deceased. In fact, it has been highlighted that both options are possible to deliver a child. Scientific researches about Utx had involved many continents in the world (America, Europe and Asia), to date, several groups have performed more than 70 UTx procedures in total, resulting in the delivery of more than 30 newborns according to the available literature and media. The first baby after UTx from living donor was born in Sweden by Brännström et al. in September 2014. First live birth after Utx in the United States was published in 2018 by Testa et al. After the first live birth after Utx from deceased donor in Brazil in 2017, research about Utx from brain dead donor was performed in many countries, including USA, Chech Republic and Italy. 

However, UTx is still in the experimental stage and there are many medical, surgical, psychological and ethical issues to be resolved. 

It’s necessary to investigate about comparison between live and deceased donor trial in order to understand if a better option exists or both options are equally valid. Issues about surgical retrieval (open, laparoscopy and robotic), graft explantation with vascular connessions and alternative drainage outflow (ovaric vein) are highly debated. There are also many sentences to be answered about psychological assessment, considered data of literature about the importance of psycological support in the patients affected from UFI and particulary MRKH syndrome. 

The global emergency from COVID-19 pandemic determined almost 2 million of deaths worldwide, damaged in many cases the ordinary medical assistence in the last year, overshadowing not essential services and making difficult for people to access in the hospitals for Utx.

The aim of this Special Issue is to resume the current state-of-art about UTx, discussing debated issues in UTx, and to develop new ideas for the future.

Prof. Paolo Scollo, Prof. Mats Brännström and Dr. Giuliano Testa

Guest Editors