Possibilities for fertility restoration: a new surgical technique.
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.
Sieunarine
Krishen
K
Department of Gynaecology, Chelsea and Westminster Hospital at Imperial College School of Medicine, London, United Kingdom. krishen23@hotmail.com
Zakaria
Faris B P
FB
Boyle
Deborah C M
DC
Corless
David J
DJ
Noakes
David E
DE
Lindsay
Iain
I
Lawson
Andrew
A
Ungar
Laszlo
L
Del Priores
Giuseppe
G
Smith
J Richard
JR
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*