Document Detail


Uterine autotransplantation in cynomolgus macaques: the first case of pregnancy and delivery.
MedLine Citation:
PMID:  22647448     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUNDFor women with congenital uterine infertility, or for those who have undergone hysterectomy, uterine transplantation is one of the potential treatments to regain fertility. In this study, we utilized a primate model of uterine transplantation, and evaluated the patency of our microsurgical anastomoses, and the perfusion of the transplanted uterus.METHODSTwo female cynomolgus monkeys underwent surgery. We anastomosed two arteries and one vein in Case 1 and two arteries and two veins in Case 2. The arteries used were the uterine arteries and the anastomosis was done to the external iliac artery. We used one of the ovarian veins in both animals, but resected the ovary from the Fallopian tube. Uterine arterial blood flow and uterine size were determined by intraoperative indocyanine green (ICG) angiography and ultrasonography. The biopsy of the uterine cervix was performed after surgery.RESULTSICG angiography showed that the unilateral uterine artery perfused the bilateral uterine bodies and cervix. In Case 1, ICG angiography showed the occlusion of one of the anastomosed arteries during the operation and the uterus appeared atrophied 2 months after operation. In Case 2, the transplanted uterus survived and normal menstruation occurred. The animal achieved a natural pregnancy and was delivered by the Caeserean section due to early separation of the placenta. The newborn suffered fetal distress.CONCLUSIONSThese results show the anastomosis of at least the bilateral uterine arteries and the unilateral ovarian vein is required for uterus transplantation. This is the first report of a natural pregnancy in a primate following uterine autotransplantation.
Authors:
Makoto Mihara; Iori Kisu; Hisako Hara; Takuya Iida; Jun Araki; Timothy Shim; Mitsunaga Narushima; Takumi Yamamoto; Hisashi Moriguchi; Yojiro Kato; Makoto Tonsho; Kouji Banno; Daisuke Aoki; Nobuhiko Suganuma; Noriko Kagawa; Yuji Takehara; Osamu Kato; Isao Koshima
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-30
Journal Detail:
Title:  Human reproduction (Oxford, England)     Volume:  -     ISSN:  1460-2350     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701199     Medline TA:  Hum Reprod     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Plastic and Reconstructive Surgery, University of Tokyo, Tokyo, Japan.
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