Uterus transplantation model in sheep with heterotopic whole graft and aorta and cava anastomoses

I. M. Gonzalez-Pinto, P. Tryphonopoulos, Donna Avison, Seigo Nishida, Akin Tekin, Sergio F Santiago, A. G. Tzakis

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Uterine transplantation in the sheep model has been described as a partial or whole orthotopic graft from a living donor with vascular anastomoses. As an alternative to surrogate pregnancy or adoption uterus transplantation might be indicated for cases of infertility of uterine origin. The main complications might be rejection and thrombosis. The objective of this work was to develop a model of whole uterus transplantation that was applicable to the human setting, using grafts obtained from brain-dead donors, and suitable for immunologic and viability follow-up with a reduced risk of thrombosis. Two donors and 1 recipient were operated. The first graft was used for an anatomic study; the second was used for transplantation. The donor operation consisted of an en bloc harvest of the uterus, adnexa, and proximal vagina with the distal aorta and cava. After harvest the donor sheep was humanely killed. In the recipient ewe, heterotopic implantation was performed in the lower abdomen. An End-to-side anastomoses of aorta and cava were performed below the recipient's renal vessels. A cutaneous vaginal stoma was performed in the right lower quadrant. The recipient ewe was humanely killed for an autopsy study. The anatomy of uterine veins of the ewe differs from the human. The uterine and ovarian veins join, forming the utero-ovarian vein, which drains at the confluence of the common iliac to the cava. En bloc harvesting allows for rapid graft preparation, with vascular cuffs easily anastomosed with a low risk of thrombosis. The vaginal stoma seems appropriate to facilitate follow-up and graft biopsy. This approach can be a suitable experimental model applicable to humans using grafts from brain-dead donors.

Original languageEnglish
Pages (from-to)1802-1804
Number of pages3
JournalTransplantation Proceedings
Volume45
Issue number5
DOIs
StatePublished - Jun 1 2013

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Uterus
Aorta
Sheep
Transplantation
Transplants
Tissue Donors
Veins
Thrombosis
Brain Death
Blood Vessels
Adnexa Uteri
Living Donors
Vagina
Abdomen
Infertility
Autopsy
Anatomy
Theoretical Models
Kidney
Biopsy

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Uterus transplantation model in sheep with heterotopic whole graft and aorta and cava anastomoses. / Gonzalez-Pinto, I. M.; Tryphonopoulos, P.; Avison, Donna; Nishida, Seigo; Tekin, Akin; Santiago, Sergio F; Tzakis, A. G.

In: Transplantation Proceedings, Vol. 45, No. 5, 01.06.2013, p. 1802-1804.

Research output: Contribution to journalArticle

Gonzalez-Pinto, I. M. ; Tryphonopoulos, P. ; Avison, Donna ; Nishida, Seigo ; Tekin, Akin ; Santiago, Sergio F ; Tzakis, A. G. / Uterus transplantation model in sheep with heterotopic whole graft and aorta and cava anastomoses. In: Transplantation Proceedings. 2013 ; Vol. 45, No. 5. pp. 1802-1804.
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