In 1905 he performed the first transplant of which no record (cornea). A century later, this type of treatment has evolved dramatically to meet the unique challenges of recent years science fiction. In 2005 came the first graft face (France), in 2008 the arms (Germany) and a few weeks ago, the first leg, which coordinated the surgeon Pedro Cavadas hospital La Fe de Valencia. What will the next show surgery? How uterus, eyes? Will you leave the brain transplant from a literary fantasy as has already happened with the face did not appear that the golden age of transplants spectacular will extend much longer. There may be some more, as the transplant arm "over the shoulder" studying practicing surgeon Pedro Cavadas Valencia, as announced last Friday. But experts point out that the future lies in the manufacture of organs from the use of biomaterials and patient's own stem cells that bypassing of the problems of rejection, one of the major drawbacks of this technique, and the shortage of donations. The conventional transplant (removal of tissues or organs from one person to graft on another) might is reaching the end of his tour of technical limitations (sections reconnect is not known how the central nervous system) and ethics: "Not everything that can be must do ", as the responsible for the National Transplant Organization, Rafael Matesanz. An example of the latter is the controversial uterus transplant. There are conflicting views on whether it is justified. It is technically possible and would not much more difficulty than the kidney. But is it worth in terms of cost-benefit? The team from Sahlgrenska University Hospital in Gothenburg (Sweden), which is working on it in early 2012, says yes. The patient, Ottson Sara, 25, suffers from the syndrome-Küster-Hauser Rokitanski, which affects 1 in 5,000 women and involves born without uterus, and not parts of the vagina. Sara wants a child and will do so thanks to her mother, Eva Olson, 56, will be the donor and to provide the organ in which the recipient was articulated. This is, however, the youngest of the ethical debates posed by the intervention. "As a parent I have raised all these questions. It's the only way my daughter could have a baby," Eva replied to the BBC in an interview. "The two women are very rational and thought it was just a body."The fundamental question is whether the fact that Sarah can have a child (which would be conceived by assisted reproduction techniques and born by Caesarean section because the transplanted uterus would not support a natural birth) compensates all the risks they are exposed mother and daughter. That is, previous surgery about three hours to remove the body of the mother (with all the dangers that entails) followed by a complex operation to implant another three hours with the added difficulty of the difficult location of the uterus and the reconnection of two large blood vessels that nourish the body. In addition, it is unknown if the uterus in its new location can be completely (or enough) to support functional and carry a pregnancy to term.Rafael Matesanz is not of the same opinion. The head of the ONT, the body which granted approval in Spain, believes that this case is an example that not everything can be done technically be done. Matesanz emphasizes that motherhood is useful alternatives ranging from surrogacy (called surrogates, the financial arrangement for a woman outside a son geste) to the adoption. Furthermore, he insists that the uterus is not a vital organ such as a heart, lung or liver. It is true that neither are legs, arms or face. However, in these cases, it was a positive balance in the cost-benefit. "If we are missing two arms, the degree of disability is huge, can not eat, open the door ... in these cases it is worth going through a complex, immune suppression and a long rehabilitation because it provides autonomy to the individual and substantially improves quality of life.