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Failure of first U.S. uterus transplant was caused by a common fungus

Lindsey and her husband Blake stand with Cleveland Clinic medical staff as they announce that she had received the nation's first uterus transplant.  (Marvin Fong/The Plain Dealer via AP)
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The first uterus transplant performed in the United States failed after a fungus common to women's reproductive systems caused an infection that resulted in blood loss after surgery, officials at the Cleveland Clinic said Friday.

On the same day that the 26-year-old transplant recipient was introduced to the public last month, she suffered dizziness, a sudden loss of blood pressure and an elevated heart rate, said Andreas Tzakis, the surgeon who performed the operation. The woman was rushed back into surgery, where doctors discovered that an infection had invaded the graft where the uterus was joined with her blood vessels, causing the blood loss. That forced the organ's removal.

The woman, who has been identified only by her first name, Lindsey, "is doing great" and should be going home soon, Tzakis said in an interview Friday. "She knows she is a pioneer, and she knows that there are some penalties that go with that." Under the clinic's protocol for the procedure, she would not be a candidate for another uterus right now, he said.

First U.S. uterus transplant fails after complication

The fungus, candida albicans, commonly lives in women's vaginas and other reproductive organs and causes no problems. According to the Centers for Disease Control and Prevention, excessive growth can trigger what is commonly known as a yeast infection and is easily treated in most cases.

But in a person like Lindsey, who was taking drugs to suppress her immune system and help the transplant succeed, growth can cause a more serious infection, Tzakis said.

Tests before the surgery did not reveal any issues for either Lindsey or the uterus donor, he said. But the Cleveland Clinic plans to modify its protocol to reduce the chances of this complication in future transplants, he said.

Surgeons describe first U.S. uterus transplant

The operation, performed Feb. 24, is part of a clinical trial that surgeons hope will result in 10 transplants for carefully screened recipients. The news conference at which doctors described their initial success was held about two years after the world's first uterine transplant was performed in Sweden. In October 2014, doctors there announced that one of the patients had delivered a healthy boy. Four more children have been born to women there since.

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