Involving Animal Models in Uterine Transplantation

Favre-Inhofer, Angéline; Carbonnel, Marie; Domert, Johanna; Cornet, Nathalie; Chastant-Maillard, Sylvie; Coscas, Raphaël; Vialard, François; Gélin, Valérie; Galio, Laurent; Richard, Christophe; Trabelsi, Hela; Sandra, Olivier; Ziegler, Dominique de; Chavatte-Palmer, Pascale; Ayoubi, Jean-Marc

doi:10.3389/fsurg.2022.830826

Cited by 6 publications

(3 citation statements)

References 93 publications

(103 reference statements)

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“…Our operation method showed efficiency in reducing the dissection time and decreasing the tension on the uterus. Importantly, our method did not affect the urinary tract; this was crucial because the ureter and bladder are very fragile, as supported by previous research indicating main complications of bladder devascularization, injury, and ureteral devascularization in both animal models [3] and humans [1,24].…”

Section: Discussionsupporting

confidence: 68%

“…Training on animal models is a prerequisite to implementing a human uterine transplantation program. Numerous animal models have been developed involving mice, rats, rabbits, dogs, cats, sows, and sheep [ 3 ]. The first mention of uterine transplantation, in 1927, involved a dog model but included scant reporting of the methodology and results.…”

Section: Introductionmentioning

confidence: 99%

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Anatomic characteristics and novel transplantation model of the canine uterus

Do,

Tong,

Nguyen

et al. 2023

Korean J Transplant

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Background:In Vietnam, the rate of absolute uterine factor infertility is increasing, but no study has been published on uterine transplantation. The present study was designed to comprehensively observe the canine uterine anatomy and to examine the possibility of using a living canine donor for uterine transplantation training and further research. Methods: Ten female Vietnamese mixed-breed dogs were sacrificed for anatomical research, and 15 additional pairs were used to evaluate the novel uterine transplant model. Results:The anatomic features of the canine uterus differed considerably from those of the human uterus, with the uterine vessels originating from branches of the pudendal vessels (also known as the vaginal vessels). The uterine vascular pedicle had a small diameter (1 to 1.5 mm for arteries and 1.2 to 2.0 mm for veins) and required manipulation under a microscope. To perform uterine transplantation, the donor specimen's artery and vein lengths were successfully reconstructed by anastomosis between both sides of the vasculature using autologous Y-shaped subcutaneous veins. The living-donor uterine transplantation model constructed in this study was feasible, with the transplanted uterus surviving in 86.7% of cases (13/15). Conclusions: Uterine transplantation was successfully performed in a Vietnamese canine living donor model. This model could be helpful in uterine transplantation training and improve the transplantation success rate in humans.

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Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Anatomic characteristics and novel transplantation model of the canine uterus

Do,

Tong,

Nguyen

et al. 2023

Korean J Transplant

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“…The excellent outcomes in uterine transplantations in the Swedish team, a leader in the field, are the result of long and meticulous preparation on animal models for more than 20 years [26]. The sheep animal model seems to be the most appropriate for surgical training on pelvic and uterine vessels of similar size to that of women [27].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Predictive Factors for Successful Vascular Anastomoses in a Sheep Uterine Transplantation Model

Gal

Carbonnel

Balaya

et al. 2022

JCM

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Uterine transplantation is becoming an increasingly realistic therapeutic for uterine infertility. Surgical training on large animal models such as sheep is a prerequisite for establishing a program in humans. The objective of our study was to analyze the predictive factors for successful vascular anastomoses. We performed 40 autotransplants that involved end-to-side anastomoses from the uterine to the external iliac vessels. We analyzed vessel results in terms of success or failure; a total of 78.7% of arterial and 82.9% of venous anastomoses were successful in the immediate postoperative period. In multivariate analysis, independent factors associated with immediate successful vein anastomoses were as follows: a short warm ischemia time (<2 h, OR = 0.05; 95% CI [0.003–0.88], p = 0.04), the absence of any anastomotic complications (OR = 0.06; 95% CI [0.003–0.099], p = 0.049), and their realization by a vascular surgeon (OR = 29.3; 95% CI [1.17–731.9], p = 0.04). Secondly, we showed that an increase in lactate levels greater than 2.72 mmol/L, six hours after reperfusion was predictive of failure, with a sensibility of 85.7% and a specificity of 75.0%. In order to perfect the management of vascular anastomoses by a vascular surgeon, training on animal models and in microsurgery are mandatory in establishing a uterine transplantation program in humans.

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A new bicornuate model of rat uterus transplantation

Polenz,

Sauer,

Martin

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionUterus transplantation has revolutionized reproductive medicine for women with absolute uterine factor infertility, resulting in more than 40 reported successful live births worldwide to date. Small animal models are pivotal to refine this surgical and immunological challenging procedure aiming to enhance safety for both the mother and the child.Material and MethodsWe established a syngeneic bicornuate uterus transplantation model in young female Lewis rats. All surgical procedures were conducted by an experienced and skilled microsurgeon who organized the learning process into multiple structured steps. Animals underwent meticulous preoperative preparation and postoperative care. Transplant success was monitored by sequential biopsies, monitoring graft viability and documenting histological changes long‐term.ResultsBicornuate uterus transplantation were successfully established achieving an over 70% graft survival rate with the passage of time. The bicornuate model demonstrated safety and feasibility, yielding outcomes comparable to the unicornuate model in terms of ischemia times and complications. Longitudinal biopsies were well‐tolerated, enabling comprehensive monitoring throughout the study.ConclusionsOur novel bicornuate rat uterus transplantation model provides a distinctive opportunity for sequential biopsies at various intervals after transplantation and, therefore, comprehensive monitoring of graft health, viability, and identification of potential signs of rejection. Furthermore, this model allows for different interventions in each horn for comparative studies without interobserver differences contrary to the established unicornuate model. By closely replicating the clinical setting, this model stands as a valuable tool for ongoing research in the field of uterus transplantation, promoting further innovation and deeper insights into the intricacies of the uterus transplant procedure.

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Involving Animal Models in Uterine Transplantation

Cited by 6 publications

References 93 publications

Anatomic characteristics and novel transplantation model of the canine uterus

Anatomic characteristics and novel transplantation model of the canine uterus

Analysis of Predictive Factors for Successful Vascular Anastomoses in a Sheep Uterine Transplantation Model

A new bicornuate model of rat uterus transplantation

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