Uterine allotranspiantation in the rabbit model using a macrovascular patch technique

The uterus and its blood supply en bloc were successfully harvested with an aortic-caval macrovascular patch in animal and human cadaveric models. The objective of this study was to assess the technical feasibility of uterine allotransplantation in the rabbit. Six uterine allotransplants were performed. This involved harvesting the uterine allograft with an aortic-caval vascular patch en bloc in the donor. After 1 hour of cold ischemic storage, the uterine allograft was transplanted to the recipient using an aortic-aortal cava-caval end to side anastomosis. Our 6 rabbit recipients surgically survived the procedure. After postmortem and histological analyses in the short term, all of the uteri appeared viable with no evidence of graft vessel thromboses. Postoperative complications included limb paraplegia, pulmonary emboli, and intraperitoneal hemorrhage. The feasibility of uterine allotransplantation using a macrovascular patch, in anatomical and surgical terms, has been proven. Further research will lead to a successful program of fertility restoration.