Uterine autotransplantation in cynomolgus macaques: the first case of pregnancy and delivery

作者:Mihara Makoto*; Kisu Iori; Hara Hisako; Iida Takuya; Araki Jun; Shim Timothy; Narushima Mitsunaga; Yamamoto Takumi; Moriguchi Hisashi; Kato Yojiro; Tonsho Makoto; Banno Kouji; Aoki Daisuke; Suganuma Nobuhiko; Kagawa Noriko; Takehara Yuji; Kato Osamu; Koshima Isao
来源:Human Reproduction, 2012, 27(8): 2332-2340.
DOI:10.1093/humrep/des169

摘要

For women with congenital uterine infertility, or for those who have undergone hysterectomy, uterine transplantation is one of the potential treatments to regain fertility. In this study, we utilized a primate model of uterine transplantation, and evaluated the patency of our microsurgical anastomoses, and the perfusion of the transplanted uterus.
Two female cynomolgus monkeys underwent surgery. We anastomosed two arteries and one vein in Case 1 and two arteries and two veins in Case 2. The arteries used were the uterine arteries and the anastomosis was done to the external iliac artery. We used one of the ovarian veins in both animals, but resected the ovary from the Fallopian tube. Uterine arterial blood flow and uterine size were determined by intraoperative indocyanine green (ICG) angiography and ultrasonography. The biopsy of the uterine cervix was performed after surgery.
ICG angiography showed that the unilateral uterine artery perfused the bilateral uterine bodies and cervix. In Case 1, ICG angiography showed the occlusion of one of the anastomosed arteries during the operation and the uterus appeared atrophied 2 months after operation. In Case 2, the transplanted uterus survived and normal menstruation occurred. The animal achieved a natural pregnancy and was delivered by the Caeserean section due to early separation of the placenta. The newborn suffered fetal distress.
These results show the anastomosis of at least the bilateral uterine arteries and the unilateral ovarian vein is required for uterus transplantation. This is the first report of a natural pregnancy in a primate following uterine autotransplantation.

  • 出版日期2012-8