During the human uterine transplantation, if the vascular pedicle length is insufficient for the recipient who ever underwent radical hysterectomy. Is it possible to utilize the recipient‘s two vascular flaps ( one with the inferior epigastric artery & the other with the great saphenous vein) to anastomose and elongate the uterine artery and uterine vein respectively?
Suggest you look at this publication which has been posted onto research gate-
https://www.researchgate.net/publication/233829297_Uterine_transplantation-a_real_possibility_The_Indianapolis_consensus
Article Uterine transplantation—a real possibility? The Indianapolis consensus
Dear sir, this is interesting.
I should say that anything is possible.
I am quite interested in following the results of your present question, since I devoted many years of my academic life, as an Anatomist, to the study of the vascular aspects of the Uterus, for my PhD.
Although I devoted most of my work to microscopic aspects and endometrial vascular networks, I also performed some observations of the macrovascular aspects, with the idea of the surgical importance of the uterine vessels management.
https://www.researchgate.net/publication/265112808_Vascularizacao_do_utero_estudo_morfologico_e_experimental
(Pdf online, with original images, see pgs. 75-85 - http://hdl.handle.net/10362/5199 )
I can see from your aproach, that these studies are always modern and fundamental.
Kind regards,
Maria
Thesis Vascularização do útero: estudo morfológico e experimental
Dear Madam Maria
After browsing all figures within the paper drafted in Portuguese you uploaded, I appreciate your great work done for comparing the human uterine vasculature with the uterus of the experimental rat, which is useful for me to comprehend the accurate anatomical structure of several subtypes of human uterine bloody supply. According to these ancient pictures referenced in your paper, we may perform the safe dissection of the vascular tree on the uterine graft .
Frankly, I have no idea about the Portuguese language thus preventing me understanding your research further. Your paper shall be recommended to my colleagues who focus on the field of angiomorphology on uterine malformation.
It will always be a great pleasure to read from you. I am glad to share the surgical & follow-up situation following the UT procedure if the team leaded by Prof. Yifeng Wang perform for the recipient ever underwent radical hysterectomy.
Best regards
Dr. GW Bruce Chen
Dear Madam Deborah
Thanks for your message. I had read this article recommended by you and found no strategy on how to deal with the insufficiency of uterine vascular pedicle length.
If the uterine retrieval occurred in live donor, it is impossible to harvest the long supplying vascular pedicles including the internal illiac vessels, which may force the surgeon to seek the interpositional vascular graft as the salvage.
So what I concerned as follow: 1.There is an increasingly theoretical risk of vascular twisting, thrombus formation, anastomotic occlusion, and subsequent uterine necrosis. 2. How to fixate the skeletonized uterine artery & vein that has been elongated by the inferior epigastric artery and the great saphenous vein?
What is the optimum management of the insufficiency of uterine vascular pedicle length during the UT? Suggestions and opinions are solicited pleased.
Best regards
Dr. GW Bruce Chen
Dear Dr Chen
Suggest you ask Dr Michael Olausson who is also on Research Gate-
https://www.researchgate.net/profile/Michael_Olausson/publications
gonadal vein of either donor or recipient will be a good size matched option
Dear Dr. Brockmann
Thank you for your suggestion, I think it is possible to use it.
I will evaluate the size of this special vein during uterine retrieval producre of the muti-organ donor.
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