Li Wei1, Tao Xue2, Kai-Shan Tao3, Geng Zhang4, Guang-Yue Zhao5, Shi-Qiang Yu6, Liang Cheng6, Zhao-Xu Yang3, Min-Juan Zheng7, Fei Li8, Qiong Wang8, Ying Han9, Yong-Quan Shi9, Hai-Long Dong10, Zhi-Hong Lu10, Yun Wang7, Hong Yang1, Xiang-Dong Ma1, Shu-Juan Liu1, Hai-Xia Liu1, Li-Ze Xiong10, Bi-Liang Chen11. 1. Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China. 2. Department of Otorhinolaryngology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China. 3. Department of Hepatic and Splenic Surgery, Department of Organ Transplant Centers, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China. 4. Department of Urinary Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China. 5. Department of Osteology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China. 6. Department of Cardiac Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China. 7. Department of Ultrasound Diagnosis, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China. 8. Department of Cardiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China. 9. Department of Gastroenterology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China. 10. Department of Anesthesiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China. 11. Department of Obstetrics and Gynecology, Xijing Hospital, The Fourth Military Medical University, Xi'an, People's Republic of China. Electronic address: cblxjh@fmmu.edu.cn.
Abstract
OBJECTIVE: To report the 12-month results of the first human uterus transplantation case using robot-assisted uterine retrieval. This type of transplantation may become a treatment for permanent uterine factor infertility. DESIGN: Case study. SETTING: University hospital. PATIENT(S): A 22-year-old woman with complete müllerian agenesis who underwent a previous surgery for vaginal reconstruction. The live uterine donor was her mother. INTERVENTION(S): The uterus transplantation procedure consisted of robot-assisted uterine procurement, orthotopic replacement and fixation of the retrieved uterus, revascularization, and end-to-side anastomoses of bilateral hypogastric arteries and ovarian-uterine vein to the bilateral external iliac arteries and veins. MAIN OUTCOME MEASURE(S): Data from preoperative investigations, surgery, and follow-up (12 months). RESULT(S): The duration of the donor and recipient surgeries were 6 and 8 hours, 50 minutes, respectively. No immediate perioperative complications occurred in the recipient or donor. The recipient experienced menarche 40 days after transplant surgery, and she has had 12 menstrual cycles since the surgery. No rejection episodes occurred in the recipient. CONCLUSION(S): These results demonstrate the feasibility of live-donor uterine transplantation with a low-dose immunosuppressive protocol and the role of DaVinci robotic assistance during human uterine procurement. CLINICAL TRIAL REGISTRATION NUMBER: XJZT12Z06.
OBJECTIVE: To report the 12-month results of the first human uterus transplantation case using robot-assisted uterine retrieval. This type of transplantation may become a treatment for permanent uterine factor infertility. DESIGN: Case study. SETTING: University hospital. PATIENT(S): A 22-year-old woman with complete müllerian agenesis who underwent a previous surgery for vaginal reconstruction. The live uterine donor was her mother. INTERVENTION(S): The uterus transplantation procedure consisted of robot-assisted uterine procurement, orthotopic replacement and fixation of the retrieved uterus, revascularization, and end-to-side anastomoses of bilateral hypogastric arteries and ovarian-uterine vein to the bilateral external iliac arteries and veins. MAIN OUTCOME MEASURE(S): Data from preoperative investigations, surgery, and follow-up (12 months). RESULT(S): The duration of the donor and recipient surgeries were 6 and 8 hours, 50 minutes, respectively. No immediate perioperative complications occurred in the recipient or donor. The recipient experienced menarche 40 days after transplant surgery, and she has had 12 menstrual cycles since the surgery. No rejection episodes occurred in the recipient. CONCLUSION(S): These results demonstrate the feasibility of live-donor uterine transplantation with a low-dose immunosuppressive protocol and the role of DaVinci robotic assistance during human uterine procurement. CLINICAL TRIAL REGISTRATION NUMBER: XJZT12Z06.
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