title: Anorectal transplantation in human cadavers: mock anorectal allotransplantation.
abstract: BACKGROUND
  Anorectal transplantation is a method for patients who have lost their anorectal function or suffer from congenital anorectal dysfunction to recover this function, and this has been investigated in experimental animal models using pigs, dogs, and rats. In this study, we performed an examination of anorectal transplantation in human cadavers to investigate whether this procedure could be performed in patients.
  
  
  METHODS
  A 77-year-old woman cadaver 1 was used as the donor and a 98-year-old woman cadaver 2 was used as the recipient. Initially, abdominoperineal excision of the anus and rectum (the Miles' operation) was performed on the recipient. Next, an anorectal graft containing the pudendal nerve (PN), pudendal artery (PA), pudendal vein (PV), inferior mesenteric artery (IMA), and inferior mesenteric vein (IMV) was harvested from the donor. The donor graft was transplanted into the recipient by intestinal anastomosis and microneurovascular anastomoses orthotopically.
  
  
  RESULTS
  The diameters of the PN (right/left), IMA, and IMV were 2.5 mm/2.5 mm, 2.0 mm, and 1.5 mm, respectively, in cadaver 1, and 2.0 mm/2.0 mm, 2.0 mm, and 2.0 mm, respectively, in cadaver 2. The length of the PN, PA, PV, IMA, and IMV in the graft was sufficient to allow proper anastomosis.
  
  
  CONCLUSIONS
  This preliminary study indicated that human anorectal transplantation was possible anatomically and technically. We anticipate our study will aid in the potential future application of this procedure to human patients.
authors.affiliation: Department of Plastic Surgery, University of Tokyo, Tokyo, Japan. arakij-pla@h.u-tokyo.ac.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Araki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishizawa
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Sato
authors.forename: Munekazu
authors.initials: M
authors.lastname: Naito
authors.forename: Keiichi
authors.initials: K
authors.lastname: Akita
authors.forename: Kensuke
authors.initials: K
authors.lastname: Tashiro
authors.forename: Takuya
authors.initials: T
authors.lastname: Iida
authors.forename: Isao
authors.initials: I
authors.lastname: Koshima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery* / Q000637:transplantation*; D000714:Anastomosis, Surgical / Q000379:methods*; D002102:Cadaver; D005260:Female; D006801:Humans; D016377:Organ Transplantation / Q000379:methods*; D012007:Rectum / Q000601:surgery* / Q000637:transplantation*; D014019:Tissue Donors; D014180:Transplantation