Lee S, Mao L, Wang Y, D'Silva M, Yoo C H, Wolf P, Chung W S, Takahashi E, Chung D Y, Gittes R F
San Diego Microsurgical Institute, Mercy Hospital Medical Center, CA 92103, USA.
Microsurgery. 1995;16(4):191-8. doi: 10.1002/micr.1920160406.
A historical review of the literature concerning replantation and transplantation of reproductive organs has included studies from this laboratory, using rats, over the past 25 years. From the basic observation of ischemic and traumatic injury due to the transplantation, syngeneic testicle transplants, resulting in a partner's impregnation and histological restoration of the testicles, led to human testicular transplantation. As to the ovarian transplants, granulosa-theca cell tumors may transform into malignancies if followed for a prolonged period as intrasplenic ovaries, and high doses (15 to 20 mg/kg b.w.) of azathioprine can produce such malignant tumors in a shorter period. By caval-portal shunt, ovarian hormones enter directly into the portal blood stream and no typical granulosa-theca cell tumors were produced, owing to the fact that the liver cannot degrade all the hormones secreted by both ovaries. While en-bloc vagino-utero-ovarian transplantation in the rat is possible, no impregnation has been yet achieved. Finally, it is hypothesized that those who have acquired microsurgical techniques and have a full understanding of the anatomy of the reproductive system will not only be able to perform replantation of the penis, but also will be capable of allogeneic transplantation of genital organs, whether ethically approved or not, and sooner than one may think. In such cases a penile part may be obtained at a sex-change surgery or from a cadaveric donor, similar to other vital organ transplantation practices.
对过去25年中本实验室使用大鼠进行的生殖器官再植和移植相关文献的历史回顾。从对移植所致缺血性和创伤性损伤的基础观察来看,同基因睾丸移植导致伴侣受孕且睾丸组织学恢复,进而促成了人类睾丸移植。至于卵巢移植,脾内卵巢若长期留存,颗粒-卵泡膜细胞瘤可能会转变为恶性肿瘤,而高剂量(15至20毫克/千克体重)的硫唑嘌呤可在更短时间内引发此类恶性肿瘤。通过腔静脉-门静脉分流,卵巢激素直接进入门静脉血流,由于肝脏无法降解两侧卵巢分泌的所有激素,因此不会产生典型的颗粒-卵泡膜细胞瘤。虽然大鼠的整块阴道-子宫-卵巢移植是可行的,但尚未实现受孕。最后,有人推测,那些掌握了显微外科技术并充分了解生殖系统解剖结构的人,不仅能够进行阴茎再植,而且无论伦理上是否获批,都将能够进行生殖器官的异体移植,且比人们想象的要早。在这种情况下,阴茎部分可从变性手术中获取或取自尸体供体,这与其他重要器官移植做法类似。