Abstract：
BACKGROUND: The aim of this study was to describe perioperative management concerning the living donor uterine transplantation program at the Hospital Clinic (Barcelona, Spain), in the first successful procedure in Southern Europe.
METHODS: Before the date of surgery, both the donor and the recipient are evaluated in the outpatient clinic to detect any possible comorbidities that might complicate or altogether disallow the procedure. In the donor, with a robotically performed surgery, complications regarding cerebral and upper airway edema, as well as reduced access to the patient once docking occurs, are of utmost importance. An aggressive antithrombotic regimen must be in place that includes heparin administered both to the donor and the recipient and aspirin to the recipient. Different strategies to reduce ischemia-reperfusion injury have been studied, with reduced ischemia times currently being the most effective.
RESULTS: After surgery, both donor and recipient were taken to the intensive care unit overnight, transferred to the conventional ward the following day and discharged from the hospital within the week. The recipient had her first menstrual period 47 days after the surgery.
CONCLUSIONS: The description of challenges regarding perioperative care of women who undergo uterine transplant programs and the rationale in anesthetic management may help other teams implant this program as a solution for a disease that profoundly impairs quality of life.
METHODS: Before the date of surgery, both the donor and the recipient are evaluated in the outpatient clinic to detect any possible comorbidities that might complicate or altogether disallow the procedure. In the donor, with a robotically performed surgery, complications regarding cerebral and upper airway edema, as well as reduced access to the patient once docking occurs, are of utmost importance. An aggressive antithrombotic regimen must be in place that includes heparin administered both to the donor and the recipient and aspirin to the recipient. Different strategies to reduce ischemia-reperfusion injury have been studied, with reduced ischemia times currently being the most effective.
RESULTS: After surgery, both donor and recipient were taken to the intensive care unit overnight, transferred to the conventional ward the following day and discharged from the hospital within the week. The recipient had her first menstrual period 47 days after the surgery.
CONCLUSIONS: The description of challenges regarding perioperative care of women who undergo uterine transplant programs and the rationale in anesthetic management may help other teams implant this program as a solution for a disease that profoundly impairs quality of life.
摘要：
背景：本研究的目的是描述在医院诊所（巴塞罗那，西班牙),这是南欧第一个成功的手术。
方法：在手术日期之前，在门诊对供血者和受血者进行评估,以发现任何可能使手术复杂化或完全不允许的合并症.在捐赠者中，用机器人进行的手术，有关脑和上气道水肿的并发症，以及一旦对接发生，减少了对患者的接触，是最重要的。必须采取积极的抗血栓形成方案，包括向供体和受体施用肝素，向受体施用阿司匹林。已经研究了减少缺血再灌注损伤的不同策略，减少缺血时间是目前最有效的。
结果：手术后，捐献者和接受者都被送往重症监护室过夜，第二天转移到常规病房，并在一周内出院。手术后47天，接受者第一次月经期。
结论：关于接受子宫移植计划的妇女的围手术期护理方面的挑战以及麻醉管理的基本原理的描述可能有助于其他团队将该计划作为严重损害生活质量的疾病的解决方案。
方法：在手术日期之前，在门诊对供血者和受血者进行评估,以发现任何可能使手术复杂化或完全不允许的合并症.在捐赠者中，用机器人进行的手术，有关脑和上气道水肿的并发症，以及一旦对接发生，减少了对患者的接触，是最重要的。必须采取积极的抗血栓形成方案，包括向供体和受体施用肝素，向受体施用阿司匹林。已经研究了减少缺血再灌注损伤的不同策略，减少缺血时间是目前最有效的。
结果：手术后，捐献者和接受者都被送往重症监护室过夜，第二天转移到常规病房，并在一周内出院。手术后47天，接受者第一次月经期。
结论：关于接受子宫移植计划的妇女的围手术期护理方面的挑战以及麻醉管理的基本原理的描述可能有助于其他团队将该计划作为严重损害生活质量的疾病的解决方案。
