Uterus Transplantation as a Surgical Innovation

• Published in: Journal of bioethical inquiry Vol. 20; no. 3; pp. 367 - 378
• Main Authors: Pérez-Blanco, Alicia, Seoane, José-Antonio, Pallás, Teresa Aldabo, Nieto-Moro, Montserrat, Calonge, Rocío Núñez, de la Fuente, Alfonso, Martin, Dominique E.
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01-09-2023
• Subjects: Critical Perspectives; Critical s; Ethics; Medical Law; Medicine; Medicine & Public Health; Theory of Medicine/Bioethics; Uterus transplantation; Research ethics; Surgical innovation; Vascular composite allografts; Medical ethics
• ISSN: 1176-7529; 1872-4353
• DOI: 10.1007/s11673-023-10272-5

Uterus transplantation (UTx) research has been introduced in several countries, with trials in Sweden and the United States producing successful outcomes. The growing interest in developing UTx trials in other countries, such as Spain, the Netherlands, Japan, and Australia, raises important questions regarding the ethics of surgical innovation research in the field of UTx. This paper examines the current state of UTx in the context of the surgical innovation paradigm and IDEAL framework and discusses the ethical challenges faced by those considering the introduction of new trials. We argue that UTx remains an experimental procedure at a relatively early stage of the IDEAL framework, especially in the context of
de novo
trials, where protocols are likely to deviate from those used previously and where researchers are likely to have limited experience of UTx. We conclude that countries considering the introduction of UTx trials should build on the strengths of the reported outcomes to consolidate the evidence base and shed light on the uncertainties of the procedure. Authorities responsible for the ethical governance of UTx trials are advised to draw on the ethical framework used in the oversight of surgical innovation.