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生殖器官移植。

Transplantation of reproductive organs.

作者信息

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

机构信息

San Diego Microsurgical Institute, Mercy Hospital Medical Center, CA 92103, USA.

出版信息

Microsurgery. 1995;16(4):191-8. doi: 10.1002/micr.1920160406.

DOI:10.1002/micr.1920160406
PMID:7674907
Abstract

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.

摘要

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。

相似文献

1
Transplantation of reproductive organs.生殖器官移植。
Microsurgery. 1995;16(4):191-8. doi: 10.1002/micr.1920160406.
2
[Response of the ovarian tumors induced in intrasplenic ovarian graft to administered gonadotrophic hormones].[脾内卵巢移植诱导的卵巢肿瘤对给予的促性腺激素的反应]
Zasshi Tokyo Ika Daigaku. 1969 Jul;27(4):499-504.
3
[The effect of portacaval shunt upon intrasplenic ovarian neoplasm formation].[门腔分流术对脾内卵巢肿瘤形成的影响]
Horumon To Rinsho. 1983 Feb;31(2):155-8.
4
[Development of ovarian tumors in rats caused by intrasplenic transplants].
Nowotwory. 1971 Apr-Jun;21(2):97-102.
5
The effect of hepatic interposition on ovary-pituitary interaction.肝脏介入对卵巢-垂体相互作用的影响。
J Microsurg. 1980 May-Jun;1(6):440-6. doi: 10.1002/micr.1920010606.
6
[Influence of the uterus on the development of experimental oovarian tumours].[子宫对实验性卵巢肿瘤发生发展的影响]
Arch Gynakol. 1968;206(3):348-68. doi: 10.1007/BF00671682.
7
Effect of caval-portal shunt on ovarian tissue in rats: I. Histological observation.腔静脉-门静脉分流术对大鼠卵巢组织的影响:I. 组织学观察。
Microsurgery. 1993;14(5):334-41. doi: 10.1002/micr.1920140509.
8
A new model for inducing malignant ovarian tumours in rats.一种在大鼠中诱导恶性卵巢肿瘤的新模型。
Br J Cancer. 1973 Jul;28(1):46-54. doi: 10.1038/bjc.1973.69.
9
The histogenesis of granulosa cell tumours. An autoradiographic study of intrasplenic ovarian transplants in gonadectomized rats.颗粒细胞瘤的组织发生。对去性腺大鼠脾内卵巢移植的放射自显影研究。
Acta Unio Int Contra Cancrum. 1962;18:50-3.
10
[Pathomorphological study on the process of the generation of an experimental ovarian tumor by intra-spleen ovarian autografting in a rat (author's transl)].
Igaku Kenkyu. 1980 Jun;50(5):419-26.

引用本文的文献

1
Uterus Transplant: Does It Have Legs?子宫移植:可行吗?
J Obstet Gynaecol India. 2017 Oct;67(5):309-312. doi: 10.1007/s13224-017-1037-9. Epub 2017 Jul 21.
2
Uterine transplantation: a systematic review.子宫移植:一项系统综述。
Clinics (Sao Paulo). 2016 Nov 1;71(11):679-683. doi: 10.6061/clinics/2016(11)10.
3
First Latin uterine transplantation: we can do it!首例拉丁美洲子宫移植:我们能做到!
Clinics (Sao Paulo). 2016 Nov 1;71(11):627-628. doi: 10.6061/clinics/2016(11)01.
4
Penis Allotransplantation in Beagle Dog.比格犬阴茎异体移植
Biomed Res Int. 2016;2016:1489204. doi: 10.1155/2016/1489204. Epub 2016 Feb 8.