A Texas hospital has pulled off four uterus transplants using living donors. This is the first time procedures using living donors has been performed in the US, Time reports. 

In February, the first uterus transplant in the US was performed using a deceased donor, but it failed because of a common yeast infection.

So far, three of the uteruses have been removed because they weren't getting enough blood flow. The fourth seems to be doing well so far.

A statement from the hospital said the surgical team was "cautiously optimistic" the fourth woman's transplanted uterus would be functional.

"This is the way we advance, from learning from our mistakes," lead surgeon at Baylor University Medical Centre in Dallas, Giuliano Testa, told Time.

"I am not ashamed of being the one who will be remembered as the guy who did four [transplants] in the beginning and three failed. Even if through failure, I am going to make this work."

In the cases of the four women who went through the transplants in September, all had a condition called Mayer-Rokitansky-Küster-Hauser syndrome, in which they were born without a uterus.

For women who are born without a uterus, have one that is damaged, or have had it removed, implanting a healthy uterus gives them the chance to get pregnant and have a child.

Still, the procedure remains highly experimental, with a high failure rate. Much more research will be needed to test its safety and success. (At least one other US hospital, Brigham and Women's in Boston, is approved to attempt the procedure, according to CNN.)

Even if the surgery becomes clinically available, the financial cost to potential patients will likely be very high.

Doctors in the UK also have plans to perform procedure using non-living donors, but for now, Sweden is the only other country where uterus transplants have succeeded.

The nine procedures there used living donors, as with the Texas surgeries, and some of the women who had the procedure have gone on to have children.

The Swedish surgical team was right alongside the Baylor doctors performing the transplant in the US.

Here's how it works

  • First, surgeons take the uterus and part of the vagina from a donor, in this case a living one.
  • Then, it's transferred to the recipient. Surgeons go in and connect the uterus to the recipient's blood supply. The transplant is attached along the vagina and pelvis, but no nerves need to be attached.
  • In the case of the woman who so far has had a successful transplant here in the US, if things continue to go well (unfortunately not a sure thing at this point), in about 6-12 months she should be ready to have a kid.
  • Because the uterus isn't connected to the ovaries, she will have to use in vitro fertilisation (a procedure where the egg is fertilised outside the body, then implanted into the uterus).
  • Because the uterus will be fragile, the woman will have to deliver via a C-section.

This article was originally published by Business Insider.

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