Andraus Wellington, Ejzenberg Dani, Santos Rafael Miyashiro Nunes Dos, Mendes Luana Regina Baratelli Carelli, Arantes Rubens Macedo, Baracat Edmund Chada, D'Albuquerque Luiz Augusto Carneiro
Faculdade de Medicina da Universidade de São Paulo, Departamento de Gastroenterologia, Divisão de Transplante de Orgãos Digestivos, São Paulo/SP, Brazil.
Faculdade de Medicina da Universidade de São Paulo, Departamento de Ginecologia, São Paulo/SP, Brazil.
Clinics (Sao Paulo). 2017 Mar;72(3):178-182. doi: 10.6061/clinics/2017(03)08.
: This study reports the first four cases of a uterine transplant procedure conducted in sheep in Latin America. The aim of this study was to evaluate the success of uterine transplantation in sheep.
: The study was conducted at Laboratory of Medical Investigation 37 (LIM 37) at the University of São Paulo School of Medicine. Four healthy mature ewes weighing 40-60 kg were used as both the donor and recipient for a transplant within the same animal (auto-transplant). Institutional guidelines for the care of experimental animals were followed.
: The first two cases of auto-transplant were performed to standardize the technique. After complete uterine mobilization and isolation of the blood supply, the unilateral vascular pedicle was sectioned and anastomosed on the external iliac vessels. After standardization, the protocol was implemented. Procurement surgery was performed without complications or bleeding. After isolation of uterine arteries and veins as well as full mobilization of the uterus, ligation of the distal portion of the internal iliac vessels was performed with subsequent division and end-to-side anastomosis of the external iliac vessels. After vaginal anastomosis, the final case presented with arterial thrombosis in the left uterine artery. The left uterine artery anastomosis was re-opened and flushed with saline solution to remove the clot from the artery lumen. Anastomosis was repeated with restoration of blood flow for a few minutes before another uterine artery thrombosis appeared on the same side. All four animals were alive after the surgical procedure and were euthanized after the experimental period.
: We describe the success of four uterine auto-transplants in sheep models.
本研究报告了拉丁美洲首例在绵羊身上进行子宫移植手术的4个病例。本研究的目的是评估绵羊子宫移植的成功率。
该研究在圣保罗大学医学院医学研究实验室37（LIM 37）进行。选用4只体重40 - 60千克的健康成年母羊，在同一动物体内进行自体移植，同时作为供体和受体。遵循了实验动物护理的机构指南。
前两例自体移植用于规范技术。在子宫完全游离并分离血供后，切断单侧血管蒂并吻合于髂外血管。技术规范后，实施手术方案。获取手术顺利，无并发症及出血。在分离子宫动静脉以及子宫完全游离后，结扎髂内血管远端，随后切断并进行髂外血管端侧吻合。阴道吻合后，最后一例出现左子宫动脉血栓形成。重新打开左子宫动脉吻合口，用生理盐水冲洗以清除动脉腔内的血栓。再次进行吻合，血流恢复几分钟后，同一侧又出现子宫动脉血栓形成。所有4只动物术后存活，实验期结束后实施安乐死。
我们描述了在绵羊模型中4例子宫自体移植的成功案例。
