Pelvic vascular prospects for uterine transplantation

Abstract

While developing the technique of abdominal radical trachelectomy for conservative cervical cancer management, the vascular supply of the uterus was thoroughly examined. This was a prelude to study the possibility of uterine transplantation where initial concerns were about how uterine artery anastomosis might be achieved and the subsequent function of these vessels in pregnancy. In experiment 1, the uterine arteries in two sows were divided and reanastomosed. At 6 weeks, all sows including control were inseminated. After weaning 3 months after delivery, the sows were killed, and postmortem studies were undertaken. Successful reanastomoses of the uterine arteries were accomplished in both study sows. After insemination, pregnancy proceeded uneventfully, and both sows farrowed normally with average litter sizes. Histopathology of the uterine arteries revealed minimal intimal fibrosis across all anastomotic sites. Uterine artery anastomosis in the porcine model is feasible with subsequent normal vascular function in pregnancy of the anastomosed vessels.