Uterus transplants (UTxs) have been performed worldwide. Overall frequencies have been low, but globally initiated UTx programs are expected to increase clinical implementation. The uterus constitutes a unique immunological environment with specific features of tissue renewal and a receptive endometrium. Decidual immune cells facilitate embryo implantation and placenta development. Although UTx adds to the complexity of immunity during pregnancy and transplantation, the procedure provides a unique clinical and experimental model. We posit that understanding the distinct immunological properties at the interface of the transplanted uterus, the fetus and maternal circulation might provide valuable novel insights while improving outcomes for UTx. Here, we discuss immunological challenges and opportunities of UTx affecting mother, pregnancy and healthy livebirths.

中文翻译：

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子宫移植中的胎儿-母体免疫界面。

子宫移植（UTx）已在世界范围内进行。总体频率一直很低，但是全球发起的UTx计划有望增加临床实施。子宫构成了独特的免疫环境，具有组织更新和子宫内膜的特定特征。蜕膜免疫细胞促进胚胎着床和胎盘发育。尽管UTx增加了怀孕和移植过程中免疫的复杂性，但该程序提供了独特的临床和实验模型。我们认为，了解移植子宫，胎儿和母体循环界面的独特免疫学特性可能会提供有价值的新颖见解，同时改善UTx的预后。在这里，我们讨论了影响母亲的UTx的免疫学挑战和机遇，