Schol Ilse M, Ko Dicken S C, Cetrulo Curtis L
aDivision of Plastic and Reconstructive Surgery bCenter for Transplantation Sciences cDepartment of Urology dDepartment of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
Curr Opin Organ Transplant. 2017 Oct;22(5):484-489. doi: 10.1097/MOT.0000000000000447.
Genitourinary vascularized allotransplantation (GUVCA) is gaining interest as a treatment option for patients with functional and aesthetic urogenital tissue loss. Only three cases have been done worldwide and research on the implementation and feasibility of this procedure is in an elementary state.
The psychosocial impact and ethical considerations with GUVCA are remote, particularly because of the intimate and personal nature of genital tissue. Though two of the three penile transplantation cases are considered successful, various unexpected factors and complications have been described alongside these successes. Treatment outcome depends on a complex combination of immunological, technical, and psychosocial components that will be different per individual case. Multidisciplinary evaluation and treatment protocols should be established to ensure that the quality of life in GUVCA recipients can be increased in a safe and ethical way.
Penile transplantation represents challenging new potential to improve phallus reconstruction in patients with severe genital tissue defects, but worldwide experience with GUVCA is limited. Controlled multicenter research is required to better define the risk/benefit ratio of this experimental yet promising treatment option.
泌尿生殖系统血管化同种异体移植(GUVCA)作为一种治疗功能性和美观性泌尿生殖组织缺失患者的选择正受到关注。全球仅开展了3例该手术,且关于该手术实施及可行性的研究尚处于初级阶段。
GUVCA的社会心理影响和伦理考量尚少,尤其是鉴于生殖组织的私密和个人性质。尽管3例阴茎移植病例中有2例被认为是成功的,但在这些成功案例之外也描述了各种意外因素和并发症。治疗结果取决于免疫、技术和社会心理等多种因素的复杂组合,且因个体病例而异。应制定多学科评估和治疗方案,以确保能以安全且符合伦理的方式提高GUVCA受者的生活质量。
阴茎移植为改善严重生殖组织缺损患者的阴茎重建带来了具有挑战性的新潜力,但全球范围内GUVCA的经验有限。需要进行对照的多中心研究,以更好地界定这种具有实验性但前景光明的治疗选择的风险/收益比。