title: Possibilities for fertility restoration: a new surgical technique.
abstract: Previously published work concluded that uterine artery microvascular anastomosis in the porcine model was feasible with subsequent normal vascular function in pregnancy. of the anastomosed vessels. The objective of this study was to assess the feasibility of uterine autotransplantation in a porcine model using microvascular anastomoses. Eight large white/landrace sows of proven fertility were used. A supracervical hysterectomy with or without bilateral salpingo-oophorectomy (BSO) was performed. After 1 hour of cold storage in a transplant solution, the specimen was reintroduced and followed by stepwise vascular reanastomosis. Objective perfusion index measurements suggested adequate uterine perfusion after transplantation. Postoperatively, sow 1 survived to 3 months with no signs of oestrus, and sows 2, 6, and 8 were killed on days 6, 33, and 54, respectively, for pelvic infection. Histopathology of the uterine grafts revealed gradual vessel thromboses. Microvascular reanastomosis is feasible, however, unsuccessful in uterine autotransplantation because of gradual vessel thromboses. The porcine model is highly susceptible to postoperative infection.
authors.affiliation: Department of Gynaecology, Chelsea and Westminster Hospital at Imperial College School of Medicine, London, United Kingdom. krishen23@hotmail.com
authors.forename: Krishen
authors.initials: K
authors.lastname: Sieunarine
authors.forename: Faris B P
authors.initials: FB
authors.lastname: Zakaria
authors.forename: Deborah C M
authors.initials: DC
authors.lastname: Boyle
authors.forename: David J
authors.initials: DJ
authors.lastname: Corless
authors.forename: David E
authors.initials: DE
authors.lastname: Noakes
authors.forename: Iain
authors.initials: I
authors.lastname: Lindsay
authors.forename: Andrew
authors.initials: A
authors.lastname: Lawson
authors.forename: Laszlo
authors.initials: L
authors.lastname: Ungar
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Del Priores
authors.forename: J Richard
authors.initials: JR
authors.lastname: Smith
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D005260:Female; D005298:Fertility; D008833:Microcirculation / Q000473:pathology / Q000601:surgery; D013552:Swine; D013927:Thrombosis / Q000473:pathology; D014182:Transplantation, Autologous; D014599:Uterus / Q000098:blood supply / Q000473:pathology / Q000637:transplantation*