Uterus Transplantation Model in Sheep With Heterotopic Whole Graft and Aorta and Cava Anastomoses

González-Pinto, I; Tryphonopoulos, Panagiotis; Avison, Donna L.; Nishida, Seigo; Tekin, Akin; Santiago, S.; Tzakis, Andreas G.

doi:10.1016/j.transproceed.2012.08.024

Cited by 19 publications

(12 citation statements)

References 6 publications

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“…The use of the sheep model for UTx can be done as deceased or live donor models. A few studies have used a deceased donor sheep model, to take large patches of the great vessels in order to facilitate the anastomoses . Gauthier et al operated on 10 sheep and followed them for a few weeks.…”

Section: Discussionmentioning

confidence: 99%

Team preparation for human uterus transplantation: Autologous transplantation in sheep model

Solomonov

Braun

Siman-Tov

et al. 2017

Clinical Transplantation

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We performed autologous uterus transplantation using the living-sheep donor model for team preparation before human uterine transplantation. Five sequential operations (in 3 ewes) were prospectively conducted. Surgical technique included uterus retrieval, graft preparation, and uterus transplantation. Anastomoses were performed at the level of the external iliac. At 3-week follow-up, the uterus and anastomoses were checked for strictures and thrombosis. Two successful auto-transplantations were made, and one failed because of undeveloped uterine arteries (< 1 mm in diameter). In the first two ewes, we identified and used a deep, separate uterine vein, which was not described in other publications. In the third ewe, we used the utero-ovarian vein. The team was able to perform safe dissection and auto-transplantation, with no signs of strictures or thrombosis after 3 weeks. Cold ischemic time was 60 minutes, and warm ischemic time was between 40 and 60 minutes, with no need for re-anastomoses. We noticed that using the deep uterine vein in the sheep model can anatomically simulate better the human uterine vein and the difficulty to approach it. To avoid using unsuitable vessels for anastomoses, the uterine transplantation protocol in humans should include imaging of the donor's uterine vessels.

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Section: Discussionmentioning

confidence: 99%

Team preparation for human uterus transplantation: Autologous transplantation in sheep model

Solomonov

Braun

Siman-Tov

et al. 2017

Clinical Transplantation

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“…There have already been several reports of animal models using anastomosis of the aorta and IVC171819, and they have reported satisfactory outcomes. However, there are no reports of stable surgical procedures of allogeneic UTx using cynomolgus macaques.…”

Section: Discussionmentioning

confidence: 99%

Surgical technique for allogeneic uterus transplantation in macaques

Obara

Kisu

Kato

et al. 2016

Sci Rep

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No study has reported an animal model of uterus transplantation (UTx) using cynomolgus macaques. We aimed to establish a surgical technique of allogeneic UTx assuming the recovery of a uterus from a deceased donor in cynomolgus macaques. Four allogeneic UTxs were performed in female cynomolgus macaques. Donor surgeries comprised en bloc recovery of organs with iliac vessels on both sides, and/or abdominal aorta/vena cava after sufficient perfusion from one femoral artery or external iliac artery. Before perfusion, 150 mL of whole blood was obtained from the donor for subsequent blood transfusion to the recipient. Four uterine grafts were orthotopically transplanted to recipients. End-to-side anastomosis was performed to the iliac vessels on one side in case 1 and iliac vessels on both sides in case 2; aorto-aorto/cavo-caval anastomosis was performed in cases 3 and 4. Arterial blood flow of the uterine grafts was determined by intraoperative indocyanine green (ICG) angiography. ICG angiography results showed sufficient blood flow to all uterine grafts, and anaemia did not progress. Under appropriate immune suppression, all recipients survived for more than 90 days post-transplantation, without any surgical complications. We describe a surgical technique for allogeneic UTx in cynomolgus macaques.

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“…The insufficiency of basic studies in this field was pointed out, and since then, basic research using animal species was started. The animal experiments regarding UTx have been conducted on small animals, such as mice, rats, and rabbits, large animals (including pigs and sheep), and non‐human primates like monkeys and baboons . Many results regarding transplantation techniques, postoperative management, immunosuppression methods, and so on have been obtained …”

Section: Basic Animal Researchmentioning

confidence: 99%

“…The animal experiments regarding UTx have been conducted on small animals, such as mice, [12][13][14][15][16] rats, [17][18][19][20][21][22] and rabbits, [23][24][25][26] large animals (including pigs [27][28][29][30][31] and sheep [32][33][34][35][36][37][38][39][40], and non-human primates like monkeys [41][42][43][44][45][46][47][48] and baboons. [49][50][51][52] Many results regarding transplantation techniques, postoperative management, immunosuppression methods, and so on have been obtained.…”

Section: Basic Animal Researchmentioning

confidence: 99%

Uterus transplantation: Toward clinical application in Japan

Suganuma

Hayashi

Kisu³

et al. 2017

Reprod Medicine & Biology

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BackgroundIn recent years, uterus transplantation (UTx) has been applied as the treatment for patients with uterine factor infertility worldwide. Thus, the clinical application of UTx in Japan should be considered through both the history of UTx technology development in the world and future prospects.MethodsRecent information on UTx was collected via a literature survey and the Internet.ResultsBasic research using various animals has been done mainly since 2000. In 2014, the world's first UTx baby was born in Sweden. In total, 24 UTx procedures have been performed at 10 institutes in nine countries and five births were obtained (as of May, 2017). In Japan, the “Project Team for Uterus Transplantation” initiated UTx experiments in 2008 and the “Japan Society for Uterus Transplantation” was organized in March, 2014. In the rest of the world, the “International Society for Uterus Transplantation” was established in January, 2016.ConclusionUterus transplantation is still under development as a reproductive medicine tool and organ transplant procedure. A collaborative system that is not limited by facilities and specialties should strive to build an “all‐Japan” team.

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Uterus Transplantation Model in Sheep With Heterotopic Whole Graft and Aorta and Cava Anastomoses

Cited by 19 publications

References 6 publications

Team preparation for human uterus transplantation: Autologous transplantation in sheep model

Team preparation for human uterus transplantation: Autologous transplantation in sheep model

Surgical technique for allogeneic uterus transplantation in macaques

Uterus transplantation: Toward clinical application in Japan

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