Absolute uterine factor infertility (AUFI) is defined as the absence (congenital or acquired) of a uterus or the presence of a non-functional uterus, e.g. severe Asherman’s, adenomyosis or fibroids. Prior to 2014, the only options for women with AUFI to obtain parenthood were either surrogacy or adoption. For many women, these options are not acceptable due to ethical, religious or financial constraints. Uterus transplantation is an emerging area and has significant research opportunities available. In 2014 the first baby was born following a uterus transplant in Sweden. Several countries have now embarked on establishing a uterus transplant program and, to date, more than 70 transplants have occurred worldwide with 18 live births reported. There is currently no international data registry, therefore these figures may not be accurate. It is proposed that a mandatory data registry becomes available to ensure accurate figures are known.

In September 2019, Royal Prince Alfred Hospital was granted ethics approval to establish a uterus transplant database which includes capturing clinical data and research outcomes. The research includes collecting patient-reported outcomes through the use of questionnaires, and collecting additional blood and tissue samples which will be stored in a biobank facility for future research studies.

This case study chronicles the journey of a patient with virally-acquired, idiopathic dilated cardiomyopathy (IDCM) experiencing progressive and pronounced heart failure symptoms acutely impacting upon his quality of life. St Vincent’s Hospital in Darlinghurst, Sydney, Australia, ensured optimal medical treatment was closely aligned with ongoing multidisciplinary support throughout the provision of specialist care. Emergent implantation of a left-ventricular assist device (LVAD) followed an associated health complication, with heart transplant workup proactively commenced by experienced transplant physicians. The mechanical circulatory support (MCS) clinic, operating within the St Vincent’s heart lung clinic, helped ensure comprehensive education and outpatient care was provided following successful clearance from allied health clinicians and discharge home with LVAD. After approximately 3 months on the transplant list, a suitable donor was found, and successful heart transplantation performed. The multidisciplinary team approach was instrumental throughout the patient’s interim and post-transplant care, helping support a safe and successful discharge home less than 2 weeks after transplant.