How the Cleveland Clinic performed the first uterus transplant in the US
Pregnancy is often one...
Last week, a team of Cleveland Clinic transplant and gynecological surgeons performed the United States’ first uterus transplant.
Pregnancy is often one of a woman’s most cherished memories, but for women with uterine factor infertility (UFI), that is not an option. They cannot carry a pregnancy because they were born without a uterus, have lost their uterus, or have a uterus that no longer functions.
Late last year, Cleveland Clinic began screening candidates for uterus transplants as part of a clinical trial approved by the company’s Institutional Review Board.
In this new research study — groundbreaking for the United States — Cleveland Clinic will perform uterus transplants in 10 women with UFI.
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With the green light, Cleveland Clinic began screening 21-to-39-year-old women with UFI for transplant. Each candidate was put through extensive rounds of medical and psychological evaluations by experts from different disciplines and must be unanimously approved by the team.
“Although there appears to be potential for treating UFI with uterine transplantation, it is still considered highly experiemental,” said Tommaso Falcone, MD, Ob/Gyn & Women’s Health Institute Chair. “Cleveland Clinic has a history of innovation in transplant and reproductive surgery and will explore the feasibility of this approach for women in the United States.”
The exact incidence of UFI is unknown, but experts estimate that it affects thousands of women of childbearing age worldwide. Some have congenital UFI, meaning that the uterus is absent at birth (as in Mayer-Rokitansky and other syndromes). Others acquire UFI after hysterectomy or because of damage from a serious pelvic infection, or abdominal or pelvic surgery.
“Women who are coping with UFI have few existing options, “said Falcone. “Although adoption and surrogacy provide opportunities for parenthood, both pose logistical challenges and may not be acceptable due to personal, cultural or legal reasons.”
Introducing Dosis - the AI powered dosing platform
Cloud-based platform Dosis uses AI to help patients and clinicians tailor their medication plans. Shivrat Chhabra, CEO and co-founder, tells us how it works.
When and why was Dosis founded?
Divya, my co-founder and I founded Dosis in 2017 with the purpose of creating a personalised dosing platform. We see personalisation in so many aspects of our lives, but not in the amount of medication we receive. We came across some research at the University of Louisville that personalised the dosing of a class of drugs called ESAs that are used to treat chronic anaemia. We thought, if commercialised, this could greatly benefit the healthcare industry by introducing precision medicine to drug dosing.
The research also showed that by taking this personalised approach, less drugs were needed to achieve the same or better outcomes. That meant that patients were exposed to less medication, so there was a lower likelihood of side effects. It also meant that the cost of care was reduced.
What is the Strategic Anemia Advisor?
Dosis’s flagship product, Strategic Anemia Advisor (SAA), personalises the dosing of Erythropoiesis Stimulating Agents (ESAs). ESAs are a class of drugs used to treat chronic anaemia, a common complication of chronic kidney disease.
SAA takes into account a patient’s previous ESA doses and lab levels, determines the patient’s unique response to the drug and outputs an ESA dose recommendation to keep the patient within a specified therapeutic target range. Healthcare providers use SAA as a clinical decision support tool.
What else is Dosis working on?
In the near term, we are working on releasing a personalised dosing module for IV iron, another drug that’s used in tandem with ESAs to treat chronic anaemia. We’re also working on personalising the dosing for the three drugs used to treat Mineral Bone Disorder. We’re very excited to expand our platform to these new drugs.
What are Dosis' strategic goals for the next 2-3 years?
We strongly believe that personalised dosing will be the standard of care within the next decade, and we’re honored to be a part of making that future a reality. In the next few years, we see Dosis entering partnerships with other companies that operate within value-based care environments, where tools like ours that help reduce cost while maintaining or improving outcomes are extremely useful.
What do you think AI's greatest benefits to healthcare are?
If designed well, AI in healthcare allows for a practical and usable way to deploy solutions that would not be feasible otherwise. For example, it’s possible for someone to manually solve the mathematical equations necessary to personalise drug dosing, but it is just not practical. AI in healthcare offers an exciting path forward for implementing solutions that for so long have appeared impractical or impossible.