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.

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.)

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