title: Assessment of an Alternative to the Uterine Vein for Venous Drainage in Human Uterine Transplantation: A Case Series Following Laparoscopic Hysterectomy.
abstract: OBJECTIVE
  To determine an alternative to the uterine vein, considering the utero-ovarian vein (UOV) for venous drainage in human uterine transplantation.
  
  
  METHODS
  A case series of 10 total laparoscopic hysterectomies was conducted for benign indications and a vascular study was performed ex vivo on the surgical specimen, demonstrating ipsilateral and contralateral flow between the uterine artery (UA) and UOV visualizing anastomoses between these vessels. The flow pattern was documented using heparinized saline and illustrated through fluoroscopy using Isovue-300 dye.
  
  
  RESULTS
  Successful cannulation of UA was accomplished in all 10 cases. Ipsilateral flow between the UA and UOV was demonstrated in all except one case, and contralateral flow was observed. Due to the long interval between the time of specimen retrieval and vascular study, the time to cannulation limited the ability to demonstrate ipsilateral and contralateral flow in 2 cases.
  
  
  CONCLUSIONS
  Uterine transplantation has become a viable option for women with absolute uterine factor infertility. However, this surgery requires extensive surgical dissection, and the surgical retrieval of the uterine vein proposes a challenge. We present a potential option for venous drainage in uterine transplant surgery, considering the UOV for venous drainage as an alternative to the uterine vein and a possibility for minimally invasive approach.
authors.affiliation: Department of Gynecology, Cleveland Clinic Florida, Weston, Fla., USA.
authors.forename: Katrin
authors.initials: K
authors.lastname: Arnolds
authors.forename: Nadia
authors.initials: N
authors.lastname: Gomez
authors.forename: Adam
authors.initials: A
authors.lastname: Berry
authors.forename: Kevin
authors.initials: K
authors.lastname: Stadtlander
authors.forename: Melissa
authors.initials: M
authors.lastname: Watson
authors.forename: Andreas
authors.initials: A
authors.lastname: Tzakis
authors.forename: Tommaso
authors.initials: T
authors.lastname: Falcone
authors.forename: Stephen
authors.initials: S
authors.lastname: Zimberg
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007084:Iliac Vein / Q000601:surgery*; D010535:Laparoscopy; D008875:Middle Aged; D016377:Organ Transplantation / Q000379:methods*; D012039:Regional Blood Flow; D019737:Transplants / Q000098:blood supply*; D014599:Uterus / Q000098:blood supply* / Q000601:surgery / Q000637:transplantation*