Achieving uterine auto-transplantation in a sheep model using iliac vessel anastomosis

A short-term viability study

Srdjan Saso, Gemma Petts, Meen Yau Thum, David Corless, Michael Boyd, David Noakes, Giuseppe Del Priore, Sadaf Ghaem-Maghami, James Richard Smith

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objective. To investigate, develop and evaluate anatomical, surgical and anastomotic aspects necessary for a successful uterine transplant in a large-animal model. Design. Sheep model; longitudinal study involving five ewes. Setting. Royal Veterinary College, London, UK. Population. Five ewes of proven fertility. Methods. The uterine allograft along with the internal iliacs, and uterine arterial and venous tree all intact were harvested en bloc. An end-to-side anastomosis was performed between the external iliac vessels and the internal iliac vessels of the graft using 6-0 polypropylene. Successful reperfusion of the graft was initially judged by the color shift of the uterus during reperfusion. Blood flow past the venous and arterial anastomotic sites was also ensured by visual inspection, together with pulse oximetry and multispectral imaging. Main outcome measures. Operative details (retrieval, ischemic, clamping, reperfusion and recipient hysterectomy duration); physiological profiles; gross morphology and histopathology. Results. Five autotransplants were performed. One procedure was abandoned because of the inappropriate size of sheep model. Another procedure was halted because the animal suffered from respiratory failure in the immediate intra-operative period. Three transplants were completed. In those, at least two of four possible anastomoses were finished and the grafted uteri demonstrated immediate perfusion and appropriate viability 45 min post-operatively. Conclusions. Internal to external iliac vessel anastomoses are an acceptable surgical technique that should be applied in a human model to ensure adequate subsequent uterine perfusion.

Original languageEnglish (US)
Pages (from-to)245-252
Number of pages8
JournalActa Obstetricia et Gynecologica Scandinavica
Volume94
Issue number3
DOIs
StatePublished - Mar 1 2015
Externally publishedYes

Fingerprint

Sheep
Transplantation
Reperfusion
Transplants
Uterus
Surgical Anastomosis
Perfusion
Oximetry
Polypropylenes
Autografts
Hysterectomy
Constriction
Respiratory Insufficiency
Allografts
Fertility
Longitudinal Studies
Animal Models
Color
Outcome Assessment (Health Care)
Population

Keywords

  • anastomosis
  • Composite tissue allograft
  • fertility
  • sheep
  • uterus

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Medicine(all)

Cite this

Achieving uterine auto-transplantation in a sheep model using iliac vessel anastomosis : A short-term viability study. / Saso, Srdjan; Petts, Gemma; Thum, Meen Yau; Corless, David; Boyd, Michael; Noakes, David; Del Priore, Giuseppe; Ghaem-Maghami, Sadaf; Smith, James Richard.

In: Acta Obstetricia et Gynecologica Scandinavica, Vol. 94, No. 3, 01.03.2015, p. 245-252.

Research output: Contribution to journalArticle

Saso, S, Petts, G, Thum, MY, Corless, D, Boyd, M, Noakes, D, Del Priore, G, Ghaem-Maghami, S & Smith, JR 2015, 'Achieving uterine auto-transplantation in a sheep model using iliac vessel anastomosis: A short-term viability study', Acta Obstetricia et Gynecologica Scandinavica, vol. 94, no. 3, pp. 245-252. https://doi.org/10.1111/aogs.12550
Saso, Srdjan ; Petts, Gemma ; Thum, Meen Yau ; Corless, David ; Boyd, Michael ; Noakes, David ; Del Priore, Giuseppe ; Ghaem-Maghami, Sadaf ; Smith, James Richard. / Achieving uterine auto-transplantation in a sheep model using iliac vessel anastomosis : A short-term viability study. In: Acta Obstetricia et Gynecologica Scandinavica. 2015 ; Vol. 94, No. 3. pp. 245-252.
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