A new surgical technique of uterine auto-transplantation in cynomolgus monkey: preliminary report about two cases
A new surgical technique of uterine auto-transplantation in cynomolgus monkey: preliminary report about two cases
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DOI：
10.1007/s00404-011-1901-2
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发表时间：
2012-01-01
影响因子：
2.6
通讯作者：
Aoki, Daisuke
中科院分区：
文献类型：
--
作者：
Kisu, Iori;Mihara, Makoto;Aoki, Daisuke
目的通过多种动物子宫移植实验，为子宫移植治疗人类永久性子宫因素不孕症的临床应用奠定基础。本研究的目的是通过开发新的手术技术来证实食蟹猴子宫自体移植的可行性。切除带血管移植物的子宫和阴道壁，并使用肝素化盐水进行后台准备。将带血管移植物的子宫和阴道壁分别与阴道残端和盆腔内的血管缝合。通过剖腹探查子宫植入、经腹超声检查子宫内膜增生、月经周期等指标评价移植子宫功能。结果第1只动物于术后2d死于急性肾功能衰竭。术后40天，第二只动物的第二次剖腹探查表明子宫无充血，子宫呈正常子宫的典型红色。术后经腹超声观察子宫内膜增生，月经周期性恢复，子宫功能恢复。结论本实验为食蟹猴自体子宫移植的初步报道。本研究证实了利用新的手术技术在食蟹猴中进行子宫自体移植的可行性。在对人类进行该手术之前，需要积累非人灵长类动物的基本实验数据。
Objective Uterine transplantation experiments have been performed in various animal species for future clinical applications of uterine transplantation for permanent uterine factor infertility in humans. The aim of this study was to confirm the feasibility of uterine auto-transplantation in cynomolgus monkeys by developing new surgical techniques.Methods Two female cynomolgus monkeys underwent surgery under general anesthesia. The uterus with vascular grafts and the vaginal wall was removed, and back-table preparation was performed using heparinized saline. The uterus with vascular grafts and the vaginal wall was anastomosed with the vaginal stump and blood vessels in the pelvis, respectively. The auto-transplant uterine function was evaluated by confirming engraftment of the uterus by laparotomy, endometrial proliferation by transabdominal ultrasonography and periodical menstruation.Results The first animal died due to acute renal failure 2 days after the operation. Second-look laparotomy in the second animal at 40 days after the operation indicated there was no congestion in the uterus, and the uterus showed the typical red color of a normal uterus. Thereafter, endometrial proliferation was observed by transabdominal ultrasonography and periodical menstruation was confirmed, indicating re-established uterine function.Conclusion This is the preliminary report of uterine autotransplantation in cynomolgus monkeys. This study demonstrates the feasibility of uterine auto-transplantation by using new surgical technique in cynomolgus monkeys. Accumulation of basic experimental data in non-human primates is required prior to performing the procedure in humans.