The auto-transplantation of uterus in swine: surgical techniques and long-term graft survival
Journal Title: Clinical and Experimental Obstetrics & Gynecology - Year 2019, Vol 46, Issue 1
Abstract
Objective: Uterus transplantation (UTx) provides a available treatment for women with absolute uterus-related infertility. The aim of this study was to develop surgical techniques for UTx and to observe the long-term graft survival in the swines. Materials and Methods: Ten female swines received uterus auto-transplantation surgery after general anesthesia. The operative time, ischemic time, and vascular injury in each swine were recorded. The bicornual uterus with vaginal canal and main vessel were removed, bake-table preparation was performed with cooled at 4ÅãC, and perfused with heparin saline with continuous flushing. The uterus was placed in original pelvic position. The uterus arteries and veins were end-side anastomosed with external iliac arteries and veins in the host swines. Results: One case was randomly selected as the preliminary experiment. The remaining nine cases showed that the uterine arteries and veins were anastomosed successfully and only eight cases attained long-term survival. The host in another case died four days after surgery from suspicious embolism postoperation. The blood flow of uterus arteries was observed by Doppler ultrasonography at four days after the operation and no congestion was found. The second-look laparotomy at six months after surgical was subsequently performed and the uterus showed a normal morphology and size. However, the pregnancy was unsuccessful due to the shorter observation time, and the severe adhesion and tubal obstruction after surgery may have affected pregnancy of those swines. Conclusion: These preliminary experiences suggest that the uterine auto-transplantation using the end-side vascular anastomosed method is feasible. The accumulation of basic data and experiences from swine experiments can provide important guidance for establishment of UTx in humans.
Authors and Affiliations
Xiao-Li Zhang, Wei-ping Li, Zhong-Yu Liu, Yuan-Qing Yao, Hong Xu
Keywords
Related Articles
- EP ID EP618494
- DOI 10.12891/ceog4229.2019
- Views 61
- Downloads 0
Long-term effect of first childbirth on pelvic floor muscle function: cross-sectional study
The aim of this study was to evaluate and compare the pelvic floor muscles (PFM) function of nulliparous and primiparous women with history of vaginal delivery and cesarean section. This study took place at the Women’s H...
Shifting the paradigm to an obstetric humanized care: the disparities at a tertiary care hospital in the midwest of Brazil
Objectives: This study intended to evaluate the overuse of episiotomy as a routine practice at a public referral regional hospital and the changes promoted by the widespread concept of obstetric violence. Materials and M...
Investigation of understanding the influence of age on fertility in Kаzakhstan: reality the physicians need to face in IVF clinic
Introduction: Women’s intentions to delay attempting a family until later in life is well known all over the world, but their knowledge of this behavior’s influence on fertility rate, as well as all the accompanying disa...
Transthyretin and retinol-binding protein 4 in patients with fetal growth restriction
The goal of this study was to analyze the relationship between maternal serum levels of transthyretin (TTR), retinol-binding protein 4 (RBP4), and the birth weight in fetal growth restriction (FGR). Materials and Methods...
Intestinal volvulus without malrotation in a dichorionic diamniotic twin: case report and review of literature
Volvulus is a condition in which the small bowel and proximal colon twist around the superior mesenteric artery, and a surgical emergency associated with high intrauterine morbidity and mortality. Intestinal volvulus can...