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Uterine autotransplantation in cynomolgus macaques: the first case of pregnancy and delivery
BACKGROUND For women with congenital uterine infertility, or for those who have undergone hysterectomy, uterine transplantation is one of the potential treatments to regain fertility. In this study, we utilized a primate model of uterine transplantation, and evaluated the patency of our microsurgica...
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| Published in: | Human reproduction (Oxford) 2012-08, Vol.27 (8), p.2332-2340 |
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| creator | Mihara, Makoto Kisu, Iori Hara, Hisako Iida, Takuya Araki, Jun Shim, Timothy Narushima, Mitsunaga Yamamoto, Takumi Moriguchi, Hisashi Kato, Yojiro Tonsho, Makoto Banno, Kouji Aoki, Daisuke Suganuma, Nobuhiko Kagawa, Noriko Takehara, Yuji Kato, Osamu Koshima, Isao |
| description | BACKGROUND
For women with congenital uterine infertility, or for those who have undergone hysterectomy, uterine transplantation is one of the potential treatments to regain fertility. In this study, we utilized a primate model of uterine transplantation, and evaluated the patency of our microsurgical anastomoses, and the perfusion of the transplanted uterus.
METHODS
Two female cynomolgus monkeys underwent surgery. We anastomosed two arteries and one vein in Case 1 and two arteries and two veins in Case 2. The arteries used were the uterine arteries and the anastomosis was done to the external iliac artery. We used one of the ovarian veins in both animals, but resected the ovary from the Fallopian tube. Uterine arterial blood flow and uterine size were determined by intraoperative indocyanine green (ICG) angiography and ultrasonography. The biopsy of the uterine cervix was performed after surgery.
RESULTS
ICG angiography showed that the unilateral uterine artery perfused the bilateral uterine bodies and cervix. In Case 1, ICG angiography showed the occlusion of one of the anastomosed arteries during the operation and the uterus appeared atrophied 2 months after operation. In Case 2, the transplanted uterus survived and normal menstruation occurred. The animal achieved a natural pregnancy and was delivered by the Caeserean section due to early separation of the placenta. The newborn suffered fetal distress.
CONCLUSIONS
These results show the anastomosis of at least the bilateral uterine arteries and the unilateral ovarian vein is required for uterus transplantation. This is the first report of a natural pregnancy in a primate following uterine autotransplantation. |
| doi_str_mv | 10.1093/humrep/des169 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1027040934</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/humrep/des169</oup_id><sourcerecordid>1027040934</sourcerecordid><originalsourceid>FETCH-LOGICAL-c461t-292e52aab7307ea23f52cca889bbfeb1d0ee7afe6a36b9797ec491f59893b1f13</originalsourceid><addsrcrecordid>eNqFkE1LxDAQhoMoun4cvUougpdqkmbTxpuIXyB4cW9CmaaTtdImNUmF_fd22VWPHoaZw8M7Mw8hp5xdcqbzq_exDzhcNRi50jtkxqVimcjnbJfMmFBlxrniB-Qwxg_GprFU--RACCULKcsZeVskDK1DCmPyKYCLQwcuQWq9o62jZuV877vlGGkPBj5HjNc0vSO1bYiJGohIvaVDwKUDZ1YUXEMb7NovDKtjsmehi3iy7UdkcX_3evuYPb88PN3ePGdGKp4yoQXOBUBd5KxAELmdC2OgLHVdW6x5wxALsKggV7UudIFGam7nutR5zS3Pj8jFJncIfn1hqvo2GuymT9CPseJMFExOtuSEZhvUBB9jQFsNoe0hrCaoWgutNkKrjdCJP9tGj3WPzS_9Y3ACzrcARAOdnRSaNv5xist8Xb83-nH4Z-c3VV6QYQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1027040934</pqid></control><display><type>article</type><title>Uterine autotransplantation in cynomolgus macaques: the first case of pregnancy and delivery</title><source>Oxford University Press</source><creator>Mihara, Makoto ; Kisu, Iori ; Hara, Hisako ; Iida, Takuya ; Araki, Jun ; Shim, Timothy ; Narushima, Mitsunaga ; Yamamoto, Takumi ; Moriguchi, Hisashi ; Kato, Yojiro ; Tonsho, Makoto ; Banno, Kouji ; Aoki, Daisuke ; Suganuma, Nobuhiko ; Kagawa, Noriko ; Takehara, Yuji ; Kato, Osamu ; Koshima, Isao</creator><creatorcontrib>Mihara, Makoto ; Kisu, Iori ; Hara, Hisako ; Iida, Takuya ; Araki, Jun ; Shim, Timothy ; Narushima, Mitsunaga ; Yamamoto, Takumi ; Moriguchi, Hisashi ; Kato, Yojiro ; Tonsho, Makoto ; Banno, Kouji ; Aoki, Daisuke ; Suganuma, Nobuhiko ; Kagawa, Noriko ; Takehara, Yuji ; Kato, Osamu ; Koshima, Isao</creatorcontrib><description>BACKGROUND
For women with congenital uterine infertility, or for those who have undergone hysterectomy, uterine transplantation is one of the potential treatments to regain fertility. In this study, we utilized a primate model of uterine transplantation, and evaluated the patency of our microsurgical anastomoses, and the perfusion of the transplanted uterus.
METHODS
Two female cynomolgus monkeys underwent surgery. We anastomosed two arteries and one vein in Case 1 and two arteries and two veins in Case 2. The arteries used were the uterine arteries and the anastomosis was done to the external iliac artery. We used one of the ovarian veins in both animals, but resected the ovary from the Fallopian tube. Uterine arterial blood flow and uterine size were determined by intraoperative indocyanine green (ICG) angiography and ultrasonography. The biopsy of the uterine cervix was performed after surgery.
RESULTS
ICG angiography showed that the unilateral uterine artery perfused the bilateral uterine bodies and cervix. In Case 1, ICG angiography showed the occlusion of one of the anastomosed arteries during the operation and the uterus appeared atrophied 2 months after operation. In Case 2, the transplanted uterus survived and normal menstruation occurred. The animal achieved a natural pregnancy and was delivered by the Caeserean section due to early separation of the placenta. The newborn suffered fetal distress.
CONCLUSIONS
These results show the anastomosis of at least the bilateral uterine arteries and the unilateral ovarian vein is required for uterus transplantation. This is the first report of a natural pregnancy in a primate following uterine autotransplantation.</description><identifier>ISSN: 0268-1161</identifier><identifier>EISSN: 1460-2350</identifier><identifier>DOI: 10.1093/humrep/des169</identifier><identifier>PMID: 22647448</identifier><identifier>CODEN: HUREEE</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Anastomosis, Surgical ; Angiography - methods ; Animals ; Biological and medical sciences ; Biopsy ; Blood Flow Velocity ; Female ; Gynecology. Andrology. Obstetrics ; Indocyanine Green - pharmacology ; Macaca fascicularis ; Medical sciences ; Transplantation, Autologous ; Ultrasonography, Doppler - methods ; Uterus - blood supply ; Uterus - immunology ; Uterus - pathology ; Uterus - transplantation</subject><ispartof>Human reproduction (Oxford), 2012-08, Vol.27 (8), p.2332-2340</ispartof><rights>The Author 2012. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com 2012</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c461t-292e52aab7307ea23f52cca889bbfeb1d0ee7afe6a36b9797ec491f59893b1f13</citedby><cites>FETCH-LOGICAL-c461t-292e52aab7307ea23f52cca889bbfeb1d0ee7afe6a36b9797ec491f59893b1f13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,1591,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26143614$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22647448$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mihara, Makoto</creatorcontrib><creatorcontrib>Kisu, Iori</creatorcontrib><creatorcontrib>Hara, Hisako</creatorcontrib><creatorcontrib>Iida, Takuya</creatorcontrib><creatorcontrib>Araki, Jun</creatorcontrib><creatorcontrib>Shim, Timothy</creatorcontrib><creatorcontrib>Narushima, Mitsunaga</creatorcontrib><creatorcontrib>Yamamoto, Takumi</creatorcontrib><creatorcontrib>Moriguchi, Hisashi</creatorcontrib><creatorcontrib>Kato, Yojiro</creatorcontrib><creatorcontrib>Tonsho, Makoto</creatorcontrib><creatorcontrib>Banno, Kouji</creatorcontrib><creatorcontrib>Aoki, Daisuke</creatorcontrib><creatorcontrib>Suganuma, Nobuhiko</creatorcontrib><creatorcontrib>Kagawa, Noriko</creatorcontrib><creatorcontrib>Takehara, Yuji</creatorcontrib><creatorcontrib>Kato, Osamu</creatorcontrib><creatorcontrib>Koshima, Isao</creatorcontrib><title>Uterine autotransplantation in cynomolgus macaques: the first case of pregnancy and delivery</title><title>Human reproduction (Oxford)</title><addtitle>Hum Reprod</addtitle><description>BACKGROUND
For women with congenital uterine infertility, or for those who have undergone hysterectomy, uterine transplantation is one of the potential treatments to regain fertility. In this study, we utilized a primate model of uterine transplantation, and evaluated the patency of our microsurgical anastomoses, and the perfusion of the transplanted uterus.
METHODS
Two female cynomolgus monkeys underwent surgery. We anastomosed two arteries and one vein in Case 1 and two arteries and two veins in Case 2. The arteries used were the uterine arteries and the anastomosis was done to the external iliac artery. We used one of the ovarian veins in both animals, but resected the ovary from the Fallopian tube. Uterine arterial blood flow and uterine size were determined by intraoperative indocyanine green (ICG) angiography and ultrasonography. The biopsy of the uterine cervix was performed after surgery.
RESULTS
ICG angiography showed that the unilateral uterine artery perfused the bilateral uterine bodies and cervix. In Case 1, ICG angiography showed the occlusion of one of the anastomosed arteries during the operation and the uterus appeared atrophied 2 months after operation. In Case 2, the transplanted uterus survived and normal menstruation occurred. The animal achieved a natural pregnancy and was delivered by the Caeserean section due to early separation of the placenta. The newborn suffered fetal distress.
CONCLUSIONS
These results show the anastomosis of at least the bilateral uterine arteries and the unilateral ovarian vein is required for uterus transplantation. This is the first report of a natural pregnancy in a primate following uterine autotransplantation.</description><subject>Anastomosis, Surgical</subject><subject>Angiography - methods</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>Blood Flow Velocity</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Indocyanine Green - pharmacology</subject><subject>Macaca fascicularis</subject><subject>Medical sciences</subject><subject>Transplantation, Autologous</subject><subject>Ultrasonography, Doppler - methods</subject><subject>Uterus - blood supply</subject><subject>Uterus - immunology</subject><subject>Uterus - pathology</subject><subject>Uterus - transplantation</subject><issn>0268-1161</issn><issn>1460-2350</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNqFkE1LxDAQhoMoun4cvUougpdqkmbTxpuIXyB4cW9CmaaTtdImNUmF_fd22VWPHoaZw8M7Mw8hp5xdcqbzq_exDzhcNRi50jtkxqVimcjnbJfMmFBlxrniB-Qwxg_GprFU--RACCULKcsZeVskDK1DCmPyKYCLQwcuQWq9o62jZuV877vlGGkPBj5HjNc0vSO1bYiJGohIvaVDwKUDZ1YUXEMb7NovDKtjsmehi3iy7UdkcX_3evuYPb88PN3ePGdGKp4yoQXOBUBd5KxAELmdC2OgLHVdW6x5wxALsKggV7UudIFGam7nutR5zS3Pj8jFJncIfn1hqvo2GuymT9CPseJMFExOtuSEZhvUBB9jQFsNoe0hrCaoWgutNkKrjdCJP9tGj3WPzS_9Y3ACzrcARAOdnRSaNv5xist8Xb83-nH4Z-c3VV6QYQ</recordid><startdate>20120801</startdate><enddate>20120801</enddate><creator>Mihara, Makoto</creator><creator>Kisu, Iori</creator><creator>Hara, Hisako</creator><creator>Iida, Takuya</creator><creator>Araki, Jun</creator><creator>Shim, Timothy</creator><creator>Narushima, Mitsunaga</creator><creator>Yamamoto, Takumi</creator><creator>Moriguchi, Hisashi</creator><creator>Kato, Yojiro</creator><creator>Tonsho, Makoto</creator><creator>Banno, Kouji</creator><creator>Aoki, Daisuke</creator><creator>Suganuma, Nobuhiko</creator><creator>Kagawa, Noriko</creator><creator>Takehara, Yuji</creator><creator>Kato, Osamu</creator><creator>Koshima, Isao</creator><general>Oxford University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120801</creationdate><title>Uterine autotransplantation in cynomolgus macaques: the first case of pregnancy and delivery</title><author>Mihara, Makoto ; Kisu, Iori ; Hara, Hisako ; Iida, Takuya ; Araki, Jun ; Shim, Timothy ; Narushima, Mitsunaga ; Yamamoto, Takumi ; Moriguchi, Hisashi ; Kato, Yojiro ; Tonsho, Makoto ; Banno, Kouji ; Aoki, Daisuke ; Suganuma, Nobuhiko ; Kagawa, Noriko ; Takehara, Yuji ; Kato, Osamu ; Koshima, Isao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c461t-292e52aab7307ea23f52cca889bbfeb1d0ee7afe6a36b9797ec491f59893b1f13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Anastomosis, Surgical</topic><topic>Angiography - methods</topic><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>Blood Flow Velocity</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Indocyanine Green - pharmacology</topic><topic>Macaca fascicularis</topic><topic>Medical sciences</topic><topic>Transplantation, Autologous</topic><topic>Ultrasonography, Doppler - methods</topic><topic>Uterus - blood supply</topic><topic>Uterus - immunology</topic><topic>Uterus - pathology</topic><topic>Uterus - transplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mihara, Makoto</creatorcontrib><creatorcontrib>Kisu, Iori</creatorcontrib><creatorcontrib>Hara, Hisako</creatorcontrib><creatorcontrib>Iida, Takuya</creatorcontrib><creatorcontrib>Araki, Jun</creatorcontrib><creatorcontrib>Shim, Timothy</creatorcontrib><creatorcontrib>Narushima, Mitsunaga</creatorcontrib><creatorcontrib>Yamamoto, Takumi</creatorcontrib><creatorcontrib>Moriguchi, Hisashi</creatorcontrib><creatorcontrib>Kato, Yojiro</creatorcontrib><creatorcontrib>Tonsho, Makoto</creatorcontrib><creatorcontrib>Banno, Kouji</creatorcontrib><creatorcontrib>Aoki, Daisuke</creatorcontrib><creatorcontrib>Suganuma, Nobuhiko</creatorcontrib><creatorcontrib>Kagawa, Noriko</creatorcontrib><creatorcontrib>Takehara, Yuji</creatorcontrib><creatorcontrib>Kato, Osamu</creatorcontrib><creatorcontrib>Koshima, Isao</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Human reproduction (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mihara, Makoto</au><au>Kisu, Iori</au><au>Hara, Hisako</au><au>Iida, Takuya</au><au>Araki, Jun</au><au>Shim, Timothy</au><au>Narushima, Mitsunaga</au><au>Yamamoto, Takumi</au><au>Moriguchi, Hisashi</au><au>Kato, Yojiro</au><au>Tonsho, Makoto</au><au>Banno, Kouji</au><au>Aoki, Daisuke</au><au>Suganuma, Nobuhiko</au><au>Kagawa, Noriko</au><au>Takehara, Yuji</au><au>Kato, Osamu</au><au>Koshima, Isao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Uterine autotransplantation in cynomolgus macaques: the first case of pregnancy and delivery</atitle><jtitle>Human reproduction (Oxford)</jtitle><addtitle>Hum Reprod</addtitle><date>2012-08-01</date><risdate>2012</risdate><volume>27</volume><issue>8</issue><spage>2332</spage><epage>2340</epage><pages>2332-2340</pages><issn>0268-1161</issn><eissn>1460-2350</eissn><coden>HUREEE</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>BACKGROUND
For women with congenital uterine infertility, or for those who have undergone hysterectomy, uterine transplantation is one of the potential treatments to regain fertility. In this study, we utilized a primate model of uterine transplantation, and evaluated the patency of our microsurgical anastomoses, and the perfusion of the transplanted uterus.
METHODS
Two female cynomolgus monkeys underwent surgery. We anastomosed two arteries and one vein in Case 1 and two arteries and two veins in Case 2. The arteries used were the uterine arteries and the anastomosis was done to the external iliac artery. We used one of the ovarian veins in both animals, but resected the ovary from the Fallopian tube. Uterine arterial blood flow and uterine size were determined by intraoperative indocyanine green (ICG) angiography and ultrasonography. The biopsy of the uterine cervix was performed after surgery.
RESULTS
ICG angiography showed that the unilateral uterine artery perfused the bilateral uterine bodies and cervix. In Case 1, ICG angiography showed the occlusion of one of the anastomosed arteries during the operation and the uterus appeared atrophied 2 months after operation. In Case 2, the transplanted uterus survived and normal menstruation occurred. The animal achieved a natural pregnancy and was delivered by the Caeserean section due to early separation of the placenta. The newborn suffered fetal distress.
CONCLUSIONS
These results show the anastomosis of at least the bilateral uterine arteries and the unilateral ovarian vein is required for uterus transplantation. This is the first report of a natural pregnancy in a primate following uterine autotransplantation.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>22647448</pmid><doi>10.1093/humrep/des169</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Anastomosis, Surgical Angiography - methods Animals Biological and medical sciences Biopsy Blood Flow Velocity Female Gynecology. Andrology. Obstetrics Indocyanine Green - pharmacology Macaca fascicularis Medical sciences Transplantation, Autologous Ultrasonography, Doppler - methods Uterus - blood supply Uterus - immunology Uterus - pathology Uterus - transplantation |
| title | Uterine autotransplantation in cynomolgus macaques: the first case of pregnancy and delivery |
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