Uterine viability in the baboon after ligation of uterine vasculature: a pilot study to assess alternative perfusion and venous return for uterine transplantation

• Published in: Fertility and sterility Vol. 107; no. 4; pp. 1078 - 1082
• Main Authors: Shockley, Marie, Arnolds, Katrin, Beran, Benjamin, Rivas, Krishna, Escobar, Pedro, Tzakis, Andreas, Falcone, Tommaso, Sprague, Michael L., Zimberg, Stephen
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2017
• Subjects: Animals; Baboon model; donor hysterectomy; Female; Hysterectomy - adverse effects; Hysterectomy - methods; Internal Medicine; Ligation; Models, Animal; Necrosis; Obstetrics and Gynecology; Ovary - diagnostic imaging; Ovary - pathology; Ovary - surgery; Papio hamadryas; Perfusion Imaging; Pilot Projects; Regional Blood Flow; Tissue Survival; Uterine Artery - diagnostic imaging; Uterine Artery - transplantation; uterine transplant; Uterus - blood supply; Uterus - diagnostic imaging; Uterus - pathology; Uterus - transplantation; Veins - diagnostic imaging; Veins - transplantation; Baboon model; uterine transplant; donor hysterectomy
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2017.01.014

To assess, in two separate groups of baboons, uterine viability after ligation of the uterine veins and uterine viability after ligation of both the uterine arteries and veins, respectively. Prospective, observational study. Baboon breeding colony. Six naïve female Papio hamadryas baboons with indicators of normal reproductive function. Three baboons underwent surgical interruption of the uterine veins bilaterally, and three baboons underwent surgical interruption of the uterine arteries and the uterine veins bilaterally. All baboons also underwent colpotomy, cervico-vaginal reanastomosis, and intraoperative near-infrared fluorescence imaging after vessel ligation. In the postoperative period, transabdominal sonography, vaginoscopy, and endocervical biopsy were performed on all animals. Postoperative uterine and ovarian viability. Near-infrared imaging confirmed intraoperative perfusion of the uterus and cervico-vaginal anastomosis in all cases. In all subjects, sonography revealed normal uteri, and vaginoscopy revealed well-healed anastomoses. Endocervical biopsies (five of six) demonstrated pathologically normal endocervical tissue without evidence of necrosis. Cyclical sex skin turgescence and menstruation were unanimously observed. Disruption of bilateral uterine vessels does not affect uterine or ovarian viability in the baboon. Bilateral uterine artery and vein ligation furthers development of a minimally invasive approach to donor hysterectomy.