Human Uterus Retrieval From a Multi-Organ Donor

OBJECTIVE: To determine if a uterus can be retrieved for reproductive organ transplantation and to describe the surgical technique. METHODS: We participated in a local organ donor network retrieval team for over 6 months. Heart-beating, brain-dead multi-organ donors were identified through an existing donor network following routine protocols. RESULTS: After institutional review board and organ donor network approval of the uterus transplantation project, approximately 1,800 eligible organ donors were identified as required by legislation. Multi-organ procurement surgery took place in approximate 150 of these, with nine specifically consented for the uterus retrieval. Regularly performed multi-organ transplantation retrievals included the uterus without complications in eight donors. Pedicles used included the ovarian, uterine, or internal iliac vessels. After retrieval, serial histology sections throughout the period of cold ischemia, taken every 15–30 minutes, showed no signs of change over 12 hours of cold ischemia. CONCLUSION: The human uterus can be obtained from local organ donor networks using existing protocols. LEVEL OF EVIDENCE: III

[1]  Bernard Devauchelle,et al.  First human face allograft: early report , 2006, The Lancet.

[2]  D. McKay,et al.  Pregnancy in recipients of solid organs--effects on mother and child. , 2006, The New England journal of medicine.

[3]  Joshua R. Smith,et al.  Complications after fertility-preserving radical trachelectomy. , 2006, Fertility and sterility.

[4]  M. Brännström,et al.  Short-term ischaemic storage of human uterine myometrium--basic studies towards uterine transplantation. , 2005, Human reproduction.

[5]  Joshua R. Smith,et al.  Is it feasible to use a large vessel patch with a uterine allograft en bloc for uterine transplantation? , 2005, International surgery.

[6]  M. Friez,et al.  Ovarian transplantation between monozygotic twins discordant for premature ovarian failure. , 2005, The New England journal of medicine.

[7]  G. Priore,et al.  Abdominal radical trachelectomy: a fertility‐preserving option for women with early cervical cancer , 2005, BJOG : an international journal of obstetrics and gynaecology.

[8]  Joshua R. Smith,et al.  SELECTIVE VESSEL LIGATION IN THE PELVIS: AN INVALUABLE TOOL IN CERTAIN SURGICAL PROCEDURES , 2004, International Journal of Gynecologic Cancer.

[9]  A. Rebarber,et al.  Successful infertility treatment in a cancer patient with a significant personal and family history of cancer. , 2004, Journal of women's health.

[10]  M. Höckel Laterally extended endopelvic resection. Novel surgical treatment of locally recurrent cervical carcinoma involving the pelvic side wall. , 2003, Gynecologic oncology.

[11]  M. Brännström,et al.  Pregnancy in transplanted mouse uterus after long-term cold ischaemic preservation. , 2003, Human reproduction.

[12]  T. Starzl,et al.  Pregnancy after liver transplantation with tacrolimus immunosuppression: a single center’s experience update at 13 years1 , 2003, Transplantation.

[13]  H. Raffa,et al.  Transplantation of the human uterus , 2002, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[14]  M. Moritz,et al.  Report from the National Transplantation Pregnancy Registry (NTPR): outcomes of pregnancy after transplantation. , 2002, Clinical transplants.

[15]  Joshua R. Smith,et al.  Uterine Transplantation, Abdominal Trachelectomy, and Other Reproductive Options for Cancer Patients , 2001, Annals of the New York Academy of Sciences.

[16]  M. Moritz,et al.  Report from the National Transplantation Pregnancy Registry (NTPR): outcomes of pregnancy after transplantation. , 2003, Clinical transplants.

[17]  A. Addis,et al.  Risk Classification Systems for Drug Use During Pregnancy , 2000, Drug safety.

[18]  J. Davison,et al.  Drug Safety Issues in Pregnancy Following Transplantation and Immunosuppression , 1998, Drug safety.

[19]  D. Renlund,et al.  Pregnancy in Heart Transplant Recipients: Management and Outcome , 1993, Obstetrics and gynecology.

[20]  J. Shelby,et al.  Pregnancy after tubo‐ovarian transplantation , 1987, Obstetrics and gynecology.