Farkas Bálint, Kovács Kálmán, Kolumbán Szilárd, Rozanovic Martin, Hegedűs Emőke, Jancsó Gábor, Bódis József, Fazekas Gábor
1 Pécsi Tudományegyetem, Általános Orvostudományi Kar, Szülészeti és Nőgyógyászati Klinika Pécs, Édesanyák útja 17., 7624 Magyarország.
2 Humán Reprodukciós Nemzeti Laboratórium, Pécsi Tudományegyetem Pécs Magyarország.
Orv Hetil. 2024 Jul 14;165(28):1079-1085. doi: 10.1556/650.2024.33092.
Introduction: A novel method for the treatment of absolute uterine factor infertility is uterine transplantation. Objective: For the sake of team preparation for human uterine transplantation, we carried out experimental sheep animal surgeries in a prospective manner. The aim of the surgeries was the identification of the anatomical structures, the preparation of the graft, the completion of the anastomosis between the vessels, and the team practice of the specialists. Method: The feeding vessels of the uterus were dissected all the way of their origin, followed by hysterectomy with long vascular pedicles. The specimen was perfused with natrium-heparin during the one-hour long cold ischemia, then it was auto-transplanted into the ipsilateral side, after cervico-vaginal anastomoses and end-to-side vascular anastomoses to the anterior surface of the external iliac vessels. Results: In 2 of the 4 cases, the operation has been declared successful, due to the re-occurrence of color, temperature and circulation. Following the investigation, all animals were euthanized. Discussion: Uterine transplantation is a novel method of the treatment of absolute uterine factor infertility. Appropriate preparation and practice on large animal is necessary for the start of a programme. The experimental sheep model provides excellent opportunity to prepare for both live and dead donor human operations. Conclusion: We conclude that the experimental sheep model is a reliable method for the preparation for human uterus transplantation trials. Orv Hetil. 2024; 165(28): 1079–1085.
子宫移植是一种治疗绝对子宫因素不孕症的新方法。目的：为了筹备人类子宫移植团队，我们前瞻性地开展了绵羊实验性手术。手术目的是识别解剖结构、准备移植物、完成血管吻合以及让专家团队进行实操。方法：将子宫的供血血管一直解剖至其起始处，然后进行带长血管蒂的子宫切除术。在长达1小时的冷缺血期间，用肝素钠对标本进行灌注，随后在进行宫颈 - 阴道吻合以及与髂外血管前表面进行端侧血管吻合后，将其自体移植到同侧。结果：4例中有2例手术宣告成功，因为出现了颜色、温度和循环的恢复。调查结束后，所有动物均被安乐死。讨论：子宫移植是治疗绝对子宫因素不孕症的一种新方法。在开展一个项目之前，对大型动物进行适当的准备和实操是必要的。实验性绵羊模型为活体和尸体供体人类手术的准备提供了绝佳机会。结论：我们得出结论，实验性绵羊模型是一种为人类子宫移植试验做准备的可靠方法。《匈牙利医学周报》。2024年；165(28):1079 - 1085。
