Cabanel Lucile, Oubari Haïzam, Dion Ludivine, Lavoué Vincent, Randolph Mark A, Cetrulo Curtis L, Uygun Korkut, Lellouch Alexandre G, Berkane Yanis, Uygun Basak E
Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston; Plastic Surgery Research Laboratory, Department of plastic and reconstructive surgery, Massachusetts General Hospital, Harvard Medical School.
Department of Gynecology and Obstetrics, CHU de Rennes, University of Rennes.
J Vis Exp. 2024 Dec 20(214). doi: 10.3791/67357.
To date, uterus transplantation is the only option for women with absolute uterine infertility, such as those with Rokitansky syndrome, to experience pregnancy and give birth. Despite the growing interest in uterus transplantation in recent years, several issues still require further research, including ischemia-reperfusion injury and its impact on graft quality and rejection. Recent literature has highlighted a thrombotic complication rate of up to 20% following uterus transplantation. This type of complication may result from hypoxia-induced endothelial cell damage, often leading to uterine graft rejection. Hypoxia is induced during static cold storage, which remains the gold standard for graft preservation in solid organ transplantation. Recently, dynamic preservation using machine perfusion has been shown to improve the long-term storage of conventional and marginal organs by reducing ischemic and hypoxic injury. In this protocol, we aim to describe every surgical step involved in porcine uterus procurement and dynamic preservation, based on both uterine pedicles, to enable the connection and initiation of the machine perfusion protocol.
迄今为止，子宫移植是患有绝对子宫性不孕的女性（如患有 Rokitansky 综合征的女性）实现怀孕和分娩的唯一选择。尽管近年来对子宫移植的兴趣日益浓厚，但仍有几个问题需要进一步研究，包括缺血再灌注损伤及其对移植物质量和排斥反应的影响。最近的文献强调，子宫移植后血栓形成并发症的发生率高达 20%。这种并发症可能是由缺氧诱导的内皮细胞损伤引起的，常常导致子宫移植物排斥。缺氧在静态冷藏过程中诱发，而静态冷藏仍是实体器官移植中移植物保存的金标准。最近，已证明使用机器灌注进行动态保存可通过减少缺血和缺氧损伤来改善传统器官和边缘器官的长期保存。在本方案中，我们旨在描述基于双侧子宫蒂的猪子宫获取和动态保存所涉及的每一个手术步骤，以便能够连接并启动机器灌注方案。
