Transplantation of Uterus for Uterine infertiLIty From Living Donor or Deceased Donor (TULIPE)

Inclusion Criteria for UT recipient: Patient aged 18 to 40 at the time of the UT; BMI (Body Mass Index) ≤ 30 kg/m²; With AUFI (type 1 or 2 MRKH syndrome and hysterectomy); Informed about the possibility of adoption; Compatibility with the donor (ABO group, Human Leukocyte Antigen (HLA) typing); Up-to-date vaccinations; Able to reach the transplant center in less than 8 hours (applicable only for the "deceased donor" arm); Having a parental project that is formulated by a heterosexual couple, by a couple of women or by a single woman; Vaginal cup longer than 7 cm. Inclusion Criteria for a deceased brain-dead uterus donor: Any person who is brain dead and who has been duly diagnosed with the following criteria: Female gender;Age ≤ 42 years;Compatibility with the recipient (ABO group, HLA typing). Inclusion Criteria for a live uterus donor: Patient belonging to the family of the recipient (mother, sister, aunt, mother-in-law...) or any person who can prove a stable emotional relationship for more than 2 years with the recipient (paragraphs 1 and 2 of Article L.1231-1 of the Public Health Code); Age ≥ 40 years and ≤ 62 years ; BMI ≤ 30 kg/m²; Having completed all her parenthood plans and no longer having any plans of pregnancy; Having had at least one live-born child at term (i.e. after 37 weeks of of amenorrhea); If the patient is menopausal: maximum 6 years after the age of menopause (or the end of hormone replacement therapy) at the supposed date of the uterine uterine sampling; Compatibility with the recipient (ABO group, HLA typing); Normal suprapubic and/or endovaginal ultrasound or pelvic Magnetic Resonance Imaging (MRI), including uterine (no uterine abnormalities); Satisfactory uterine vessels assessed by MRI angio. Exclusion Criteria for UT recipient: Patient with acquired uterine infertility and having had one or more children; Non-stable psychological state defined by a clinical psychologist after a qualitative interview; Severe co-morbidity; Association of severe abnormality with MRKH syndrome other than renal such as a cardiac malformation; A single pelvic kidney (urinary malformation that can be associated with MRKH syndrome); Anomaly on the GREB1L (growth regulation by estrogen in breast cancer-like) gene (MRKH patient); Diabetes (HbA1c > 6%); Disorders of hemostasis: Prothrombin rate <70%; Hemoglobin abnormality; Existence of hypertension; Vaginal reconstruction (neovagina) by digestive segment (colonic plastic surgery or other); History of major abdominal or pelvic surgery; Known thrombophilia (acquired or constitutional); HIV (Human Immunodeficiency Virus), HCV (Hepatitis C Virus), HBV (Hepatitis B Virus), HAV (Hepatitis A Virus), HTLV (Human T-Lymphotropic Virus) serology positive and presence of irreversible communicable infectious diseases; Positive vaginal hPV-HR (human Papilloma Virus High Risk) test; Signs of chronic renal disease; Drug addiction or alcoholism not weaned for more than 2 years or drug addiction or excessive alcohol consumption (> 30 g/day of alcohol) current; History of cancer less than 10 years old, cancer under treatment (except in the cancer in situ, or basal cell skin lesion) or diagnosed during the selection process; History of pelvic radiotherapy or vaginal brachytherapy regardless of when this irradiation was performed; Known psychiatric pathology; Active tuberculosis (i.e. under treatment); Known or suspected contraindications to one or more of the treatments (active substance or excipient(s)) to be administered for the purposes of the study and/or essential treatment having an interaction/impact with one of the treatments planned by the research; Existence of organ dysfunction not compatible with the uterine transplantation protocol; History of smoking (defined as consumption greater than 20 packs/year) not weaned for more than 2 years or active smoker. Exclusion Criteria for a deceased brain-dead uterus donor: Initial circulatory arrest of more than 10 minutes; Opposition to organ donation (register of refusals) or to uterine removal by a relative of the deceased; Chronic and uncontrolled hypertension; Absence of uterus (history of hysterectomy or uterine agenesis); Presence of uterine pathology; Delivery less than 6 months ago or ongoing pregnancy; History of several caesarean sections (multi-scarred uterus: more than 2); History of major abdominal or pelvic surgery; Infection of the sepsis type or uncontrolled infection (bacterial, viral viral, parasitic fungal, active Chagas disease); Encephalitis of viral origin or febrile of uncertain origin or meningoencephalitis of unknown origin; Risk of Prion disease transmission; Presence of an infectious disease: HIV, HCV, HBV, HTLV and presence of irreversible communicable infectious diseases; Carrying of human Papilloma Virus High Risk (hPV-HR) class 1 positive in the genital tract if known before transplantation; Positive EBV (Epstein-Barr Virus) serology in the donor if the recipient is EBV negative for EBV ; Positive pre-transplant virtual crossmatch; Donor/recipient ABO final check in the operating room before transplantation positive; Drug addiction or alcoholism not weaned for more than 2 years or drug addiction or excessive alcohol consumption (> 30 g/day of alcohol) current; History of cancer less than 5 years old, cancer under treatment (except in the cancer in situ, or basal cell skin lesion) ; Active tuberculosis (i.e. under treatment); History of smoking (defined as consumption greater than 20 packs/year) not weaned for more than 2 years or active smoker. Exclusion Criteria for a live uterus donor: Non-stable psychological state defined by a clinical psychologist clinician after a qualitative interview; Severe co-morbidity; Diabetes (HbA1c > 6%); Hemostasis disorders: Prothrombin rate <70%; Hemoglobin abnormality; hypertension treated with more than 2 antihypertensive drugs; Delivery less than 6 months ago or ongoing pregnancy; History of cervical pathology; History of recurrent miscarriage syndrome (defined as 3 consecutive consecutive miscarriages); History of premature delivery before 36 weeks of amenorrhea; History of pre-eclampsia; History of caesarean sections; History of major uterine surgery; History of major abdominal or pelvic surgery; Endometrial biopsy and diagnostic hysteroscopy showing an abnormality of the endometrium; Known thrombophilia (acquired or constitutional); HIV, HCV, HBV, HTLV serology positive and presence of irreversible communicable infectious diseases; Positive vaginal hPV-HR (human Papilloma Virus High Risk) test; PCR (Polymerase Chain reaction) on HSV (Herpes Simplex Virus) 1/2 positive sample; Abnormal Pap smear; Signs of chronic kidney disease; Risks of Prion disease transmission; Drug addiction or alcoholism not weaned for more than 2 years or drug addiction or excessive alcohol consumption (> 30 g/day of alcohol) current; History of cancer less than 10 years old, cancer under treatment (except in the cancer in situ, or basal cell skin lesion) or diagnosed during the selection process; History of pelvic radiotherapy or vaginal brachytherapy regardless of when this irradiation was performed; Known psychiatric pathology; Active tuberculosis (i.e. under treatment); Presence of a known thromboembolic risk factor; Angio-MRI, CT angiography and/or arteriography revealing an anomaly incompatible with uterine transplantation; History of smoking (defined as consumption greater than 20 packs/year) not weaned for more than 2 years or active smoker.