Obara Hideaki, Kisu Iori, Kato Yojiro, Yamada Yohei, Matsubara Kentaro, Emoto Katsura, Adachi Masataka, Matoba Yusuke, Umene Kiyoko, Nogami Yuya, Banno Kouji, Tsuchiya Hideaki, Itagaki Iori, Kawamoto Ikuo, Nakagawa Takahiro, Ishigaki Hirohito, Itoh Yasushi, Ogasawara Kazumasa, Saiki Yoko, Sato Shin-Ichi, Nakagawa Kenshi, Shiina Takashi, Aoki Daisuke, Kitagawa Yuko
Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
Sci Rep. 2016 Oct 27;6:35989. doi: 10.1038/srep35989.
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.
尚无研究报道使用食蟹猴建立子宫移植（UTx）的动物模型。我们旨在建立一种同种异体子宫移植的手术技术，设想从食蟹猴尸体供体获取子宫。对雌性食蟹猴进行了4例同种异体子宫移植。供体手术包括从一侧股动脉或髂外动脉充分灌注后，整体回收双侧带髂血管的器官，和/或腹主动脉/腔静脉。灌注前，从供体获取150 mL全血，用于随后给受体输血。将4个子宫移植物原位移植到受体。病例1对一侧髂血管进行端侧吻合，病例2对双侧髂血管进行端侧吻合；病例3和4进行主动脉-主动脉/腔静脉-腔静脉吻合。术中通过吲哚菁绿（ICG）血管造影确定子宫移植物的动脉血流。ICG血管造影结果显示所有子宫移植物血流充足，且贫血未进展。在适当的免疫抑制下，所有受体移植后存活超过90天，无任何手术并发症。我们描述了食蟹猴同种异体子宫移植的手术技术。
