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(Reporter Xu Shiyu from People's Daily Health Client) On July 13, the artificial uterus team of the First Affiliated Hospital of Zhengzhou University completed an animal experiment on "ECMO-free artificial uterus". A 4-month-old fetus survived for a full 90 minutes in an artificial uterus that was separated from its mother and did not require ECMO. After literature search, this experiment is the first of its kind in the world.

On July 26, Zhao Gaofeng, head of the artificial uterus team and director of lung transplant surgery at the First Affiliated Hospital of Zhengzhou University, told a reporter from the People's Daily Health Client that the artificial uterus mainly hopes to solve medical problems such as the survival of extremely premature babies and extrauterine surgery. Current research is still at the animal experiment level, and its ethical discussions are still ongoing.

"Animal experiments on artificial uterus assisted by ECMO have been relatively mature worldwide. The artificial uterus without ECMO is still a first in my country, which means that another living organism can be used instead of ECMO to supply oxygen to the fetal sheep. If the other living organism has the same blood type as the fetal sheep, then both the father and the mother can play the role of raising the fetus," Zhao Gaofeng introduced.

Artificial uterus is not a new concept. In 1924, British scientist Haldane proposed the concept of artificial uterus and exogenous uterus. In 1969, the research team of Massachusetts General Hospital in the United States first put artificial uterus technology into animal experiments through silicone membrane blood oxygenator and parenteral nutrition support system. The premature sheep fetus maintained normal development and metabolism in vitro for several days. In addition to the United States, several teams in Japan, the Netherlands and other countries have also conducted animal experiments on artificial uterus.

In 2021, the artificial uterus research team of the First Affiliated Hospital of Zhengzhou University completed the first ECMO-assisted artificial uterus animal experiment in China.

Talking about the original intention of the artificial uterus, Zhao Gaofeng admitted that it was for the purpose of performing surgery on the fetus: "Intrauterine surgery has great limitations, as it is impossible to open the fetus's chest cavity. But if an extrauterine surgery is performed, how can the fetus continue to live?" Based on this idea, doctors from multiple departments including the Department of Thoracic Surgery, Department of Obstetrics and Gynecology, Department of Anesthesiology, and Department of Extracorporeal Circulation of the First Affiliated Hospital of Zhengzhou University began an animal experiment on an artificial uterus.

Multiple animal experiments have allowed the team to see more problems. Zhao Gaofeng said that ECMO is expensive to use, with a startup cost of 60,000 to 70,000 yuan and an average daily operating cost of 10,000 to 20,000 yuan. In addition, complications such as blood clots may form during the use of ECMO.

After much discussion, the ECMO-free artificial uterus animal experiment was put on the agenda. On July 13, a 4-month-old fetus was taken out of its mother's body. Doctors connected the fetus' umbilical artery and umbilical vein to the mother's neck artery and vein to establish a paracortical circulation similar to ECMO. The little fetus, taken out of its mother's body, survived for a full 90 minutes in the artificial uterus outside the mother's body.

"Although our country started late in the field of artificial uterus, we have started animal experiments on artificial uterus without ECMO, which is at the forefront in terms of concept." Zhao Gaofeng introduced that the artificial uterus is still a very cutting-edge scientific research, and the animal experiments on artificial uterus without ECMO will be continuously optimized, hoping to extend the survival time of fetal sheep outside the mother's body from 90 minutes to one day, one month or even longer.

The research on artificial uterus also faces various ethical issues. Zhao Gaofeng and his team are also looking forward to the artificial uterus being truly applied in clinical practice to solve more medical problems.