title: Sheep Model for Uterine Transplantation: The Best Option Before Starting a Human Program.
abstract: This study reports the first four cases of a uterine transplant procedure conducted in sheep in Latin America. The aim of this study was to evaluate the success of uterine transplantation in sheep.
  The study was conducted at Laboratory of Medical Investigation 37 (LIM 37) at the University of São Paulo School of Medicine. Four healthy mature ewes weighing 40-60 kg were used as both the donor and recipient for a transplant within the same animal (auto-transplant). Institutional guidelines for the care of experimental animals were followed.
  The first two cases of auto-transplant were performed to standardize the technique. After complete uterine mobilization and isolation of the blood supply, the unilateral vascular pedicle was sectioned and anastomosed on the external iliac vessels. After standardization, the protocol was implemented. Procurement surgery was performed without complications or bleeding. After isolation of uterine arteries and veins as well as full mobilization of the uterus, ligation of the distal portion of the internal iliac vessels was performed with subsequent division and end-to-side anastomosis of the external iliac vessels. After vaginal anastomosis, the final case presented with arterial thrombosis in the left uterine artery. The left uterine artery anastomosis was re-opened and flushed with saline solution to remove the clot from the artery lumen. Anastomosis was repeated with restoration of blood flow for a few minutes before another uterine artery thrombosis appeared on the same side. All four animals were alive after the surgical procedure and were euthanized after the experimental period.
  We describe the success of four uterine auto-transplants in sheep models.
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, Departamento de Gastroenterologia, Divisão de Transplante de Orgãos Digestivos, São Paulo/SP, Brazil.
authors.forename: Wellington
authors.initials: W
authors.lastname: Andraus
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, Departamento de Ginecologia, São Paulo/SP, Brazil.
authors.forename: Dani
authors.initials: D
authors.lastname: Ejzenberg
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, Departamento de Gastroenterologia, Divisão de Transplante de Orgãos Digestivos, São Paulo/SP, Brazil.
authors.forename: Rafael Miyashiro Nunes Dos
authors.initials: RM
authors.lastname: Santos
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, Departamento de Gastroenterologia, Divisão de Transplante de Orgãos Digestivos, São Paulo/SP, Brazil.
authors.forename: Luana Regina Baratelli Carelli
authors.initials: LR
authors.lastname: Mendes
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, Departamento de Gastroenterologia, Divisão de Transplante de Orgãos Digestivos, São Paulo/SP, Brazil.
authors.forename: Rubens Macedo
authors.initials: RM
authors.lastname: Arantes
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, Departamento de Ginecologia, São Paulo/SP, Brazil.
authors.forename: Edmund Chada
authors.initials: EC
authors.lastname: Baracat
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, Departamento de Gastroenterologia, Divisão de Transplante de Orgãos Digestivos, São Paulo/SP, Brazil.
authors.forename: Luiz Augusto Carneiro
authors.initials: LA
authors.lastname: D'Albuquerque
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D007083:Iliac Artery / Q000601:surgery; D007247:Infertility, Female / Q000601:surgery; D023421:Models, Animal; D015424:Reperfusion; D015203:Reproducibility of Results; D012756:Sheep / Q000601:surgery*; D014182:Transplantation, Autologous; D014599:Uterus / Q000098:blood supply / Q000637:transplantation*