title: Uterine viability in the baboon after ligation of uterine vasculature: a pilot study to assess alternative perfusion and venous return for uterine transplantation.
abstract: OBJECTIVE
  To assess, in two separate groups of baboons, uterine viability after ligation of the uterine veins and uterine viability after ligation of both the uterine arteries and veins, respectively.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  Baboon breeding colony.
  
  
  METHODS
  Six naïve female Papio hamadryas baboons with indicators of normal reproductive function.
  
  
  METHODS
  Three baboons underwent surgical interruption of the uterine veins bilaterally, and three baboons underwent surgical interruption of the uterine arteries and the uterine veins bilaterally. All baboons also underwent colpotomy, cervico-vaginal reanastomosis, and intraoperative near-infrared fluorescence imaging after vessel ligation. In the postoperative period, transabdominal sonography, vaginoscopy, and endocervical biopsy were performed on all animals.
  
  
  METHODS
  Postoperative uterine and ovarian viability.
  
  
  RESULTS
  Near-infrared imaging confirmed intraoperative perfusion of the uterus and cervico-vaginal anastomosis in all cases. In all subjects, sonography revealed normal uteri, and vaginoscopy revealed well-healed anastomoses. Endocervical biopsies (five of six) demonstrated pathologically normal endocervical tissue without evidence of necrosis. Cyclical sex skin turgescence and menstruation were unanimously observed.
  
  
  CONCLUSIONS
  Disruption of bilateral uterine vessels does not affect uterine or ovarian viability in the baboon. Bilateral uterine artery and vein ligation furthers development of a minimally invasive approach to donor hysterectomy.
authors.affiliation: Department of Gynecology, Cleveland Clinic Florida, Weston, Florida. Electronic address: shocklm@ccf.org.
authors.forename: Marie
authors.initials: M
authors.lastname: Shockley
authors.affiliation: Department of Gynecology, Cleveland Clinic Florida, Weston, Florida.
authors.forename: Katrin
authors.initials: K
authors.lastname: Arnolds
authors.affiliation: Department of Gynecology, Cleveland Clinic Florida, Weston, Florida.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Beran
authors.affiliation: Mannheimer Foundation, Homestead, Florida.
authors.forename: Krishna
authors.initials: K
authors.lastname: Rivas
authors.affiliation: Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Pedro
authors.initials: P
authors.lastname: Escobar
authors.affiliation: Transplantation Center, Cleveland Clinic Florida, Weston, Florida.
authors.forename: Andreas
authors.initials: A
authors.lastname: Tzakis
authors.affiliation: Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Falcone
authors.affiliation: Department of Gynecology, Cleveland Clinic Florida, Weston, Florida.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Sprague
authors.affiliation: Department of Gynecology, Cleveland Clinic Florida, Weston, Florida.
authors.forename: Stephen
authors.initials: S
authors.lastname: Zimberg
mesh_terms: D000818:Animals; D005260:Female; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods*; D008026:Ligation; D023421:Models, Animal; D009336:Necrosis; D010053:Ovary / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D048529:Papio hamadryas; D055420:Perfusion Imaging; D010865:Pilot Projects; D012039:Regional Blood Flow; D014022:Tissue Survival; D055988:Uterine Artery / Q000000981:diagnostic imaging / Q000637:transplantation*; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology / Q000637:transplantation*; D014680:Veins / Q000000981:diagnostic imaging / Q000637:transplantation*
keywords: Baboon model; donor hysterectomy; uterine transplant