title: Is it feasible to use a large vessel patch with a uterine allograft en bloc for uterine transplantation?
abstract: Uterine auto-transplantation in the porcine model using a microvascular anastomotic technique failed because of gradual vessel thromboses. A macrovascular patch harvest with the uterus en bloc is probably less likely to undergo vessel thrombosis. The objective of this study was to assess the feasibility of an aortic/inferior vena caval vascular patch harvest with the uterus en bloc for uterine cross-transplantation purposes. A preserved human cadaver and freshly killed porcine and rabbit cadaveric models were used. The infrarenal aorta, inferior vena cava, common and internal iliac vessels and the uterine arterial and venous tree together with the uterus en bloc were successfully harvested intact as a large vessel patch and graft in both animal and human models. A macrovascular patch for uterine cross-transplantation is technically easy and feasible to harvest en bloc with the uterus in fresh cadaveric donors. This technique precludes live donors and makes cadaveric organ donation essential.
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: Nadey S
authors.initials: NS
authors.lastname: Hakim
authors.forename: David J
authors.initials: DJ
authors.lastname: Corless
authors.forename: David E
authors.initials: DE
authors.lastname: Noakes
authors.forename: Laszlo
authors.initials: L
authors.lastname: Ungar
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Del Priore
authors.forename: J Richard
authors.initials: JR
authors.lastname: Smith
mesh_terms: D000818:Animals; D001012:Aorta, Abdominal / Q000601:surgery; D002102:Cadaver; D005240:Feasibility Studies; D005260:Female; D005298:Fertility; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D011817:Rabbits; D013552:Swine; D020858:Tissue and Organ Harvesting / Q000379:methods; D014184:Transplantation, Homologous; D014599:Uterus / Q000098:blood supply / Q000637:transplantation*; D014682:Vena Cava, Inferior / Q000601:surgery