title: A new surgical technique of uterine auto-transplantation in cynomolgus monkey: preliminary report about two cases.
abstract: OBJECTIVE
  Uterine transplantation experiments have been performed in various animal species for future clinical applications of uterine transplantation for permanent uterine factor infertility in humans. The aim of this study was to confirm the feasibility of uterine auto-transplantation in cynomolgus monkeys by developing new surgical techniques.
  
  
  METHODS
  Two female cynomolgus monkeys underwent surgery under general anesthesia. The uterus with vascular grafts and the vaginal wall was removed, and back-table preparation was performed using heparinized saline. The uterus with vascular grafts and the vaginal wall was anastomosed with the vaginal stump and blood vessels in the pelvis, respectively. The auto-transplant uterine function was evaluated by confirming engraftment of the uterus by laparotomy, endometrial proliferation by transabdominal ultrasonography and periodical menstruation.
  
  
  RESULTS
  The first animal died due to acute renal failure 2 days after the operation. Second-look laparotomy in the second animal at 40 days after the operation indicated there was no congestion in the uterus, and the uterus showed the typical red color of a normal uterus. Thereafter, endometrial proliferation was observed by transabdominal ultrasonography and periodical menstruation was confirmed, indicating re-established uterine function.
  
  
  CONCLUSIONS
  This is the preliminary report of uterine auto-transplantation in cynomolgus monkeys. This study demonstrates the feasibility of uterine auto-transplantation by using new surgical technique in cynomolgus monkeys. Accumulation of basic experimental data in non-human primates is required prior to performing the procedure in humans.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Iori
authors.initials: I
authors.lastname: Kisu
authors.forename: Makoto
authors.initials: M
authors.lastname: Mihara
authors.forename: Kouji
authors.initials: K
authors.lastname: Banno
authors.forename: Hisako
authors.initials: H
authors.lastname: Hara
authors.forename: Takumi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Jun
authors.initials: J
authors.lastname: Araki
authors.forename: Takuya
authors.initials: T
authors.lastname: Iida
authors.forename: Yohei
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Hisashi
authors.initials: H
authors.lastname: Moriguchi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Aoki
mesh_terms: D000818:Animals; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D008252:Macaca fascicularis; D014182:Transplantation, Autologous / Q000379:methods*; D014599:Uterus / Q000637:transplantation*