PDF(Pubmed)
Abstract：
UNASSIGNED: To study a surgical approach to venous vascular thrombosis after uterus transplantation (UTx). Uterus transplantation is the only treatment for uterine factor infertility when conventional therapies are not possible. One of the major limitations of UTx is the high incidence of vascular thrombosis, which in most series reaches approximately 20%.
UNASSIGNED: A case report.
UNASSIGNED: Hospital.
UNASSIGNED: We report here a technique used in a 30-year-old woman with congenital absence of the uterus who developed intraoperative thrombosis after a UTx from a brain-dead donor.
UNASSIGNED: The UTx was performed by revascularizing the graft through bilateral donor internal iliac vessels (artery and vein) anastomosed end-to-side to the external iliac vessels of the recipient. The superior uterine veins were not anastomosed and were left unreconstructed. An end-to-end graft to the recipient\'s vaginal anastomosis was performed. After uterus reperfusion, congestion of the organ was noted, and bilateral venous thrombosis of the internal iliac veins of the graft was found. A \"Y-shaped\" venous jump graft was used to restore venous outflow of the left superior uterine vein and the internal iliac vein of the graft after thrombectomy.
UNASSIGNED: Viability and functionality of the uterus graft after intraoperative bilateral venous thrombosis.
UNASSIGNED: The postoperative course was uneventful, and this UTx resulted in the delivery of a healthy infant.
UNASSIGNED: To our knowledge, this is the first successful rescue technique used to restore venous outflow and save the viability and functionality of a transplanted uterus. We demonstrated that a transplanted uterus from a deceased donor with a monolateral outflow could succeed in pregnancy and the delivery of a healthy infant.
UNASSIGNED: A case report.
UNASSIGNED: Hospital.
UNASSIGNED: We report here a technique used in a 30-year-old woman with congenital absence of the uterus who developed intraoperative thrombosis after a UTx from a brain-dead donor.
UNASSIGNED: The UTx was performed by revascularizing the graft through bilateral donor internal iliac vessels (artery and vein) anastomosed end-to-side to the external iliac vessels of the recipient. The superior uterine veins were not anastomosed and were left unreconstructed. An end-to-end graft to the recipient\'s vaginal anastomosis was performed. After uterus reperfusion, congestion of the organ was noted, and bilateral venous thrombosis of the internal iliac veins of the graft was found. A \"Y-shaped\" venous jump graft was used to restore venous outflow of the left superior uterine vein and the internal iliac vein of the graft after thrombectomy.
UNASSIGNED: Viability and functionality of the uterus graft after intraoperative bilateral venous thrombosis.
UNASSIGNED: The postoperative course was uneventful, and this UTx resulted in the delivery of a healthy infant.
UNASSIGNED: To our knowledge, this is the first successful rescue technique used to restore venous outflow and save the viability and functionality of a transplanted uterus. We demonstrated that a transplanted uterus from a deceased donor with a monolateral outflow could succeed in pregnancy and the delivery of a healthy infant.
摘要：
■目的研究子宫移植（UTx）后静脉血管血栓形成的手术方法。当常规疗法不可能时，子宫移植是子宫因子不孕症的唯一治疗方法。UTx的主要局限性之一是血管血栓形成的高发生率，在大多数系列中达到大约20%。
■病例报告。
■医院。
■我们在此报告了一种技术，该技术用于一名30岁先天性子宫缺失的女性，该女性在脑死亡供体的UTx术后发生术中血栓形成。
■UTx是通过双侧供体髂内血管（动脉和静脉）与受体的髂外血管端对侧吻合，对移植物进行血管重建。子宫上静脉未吻合，未重建。对受体的阴道吻合术进行端到端移植。子宫再灌注后,注意到器官充血，并发现移植物髂内静脉双侧静脉血栓形成。血栓切除术后，使用“Y形”静脉跳跃移植物恢复左上子宫静脉和移植物内静脉的静脉流出。
■术中双侧静脉血栓形成后子宫移植物的活力和功能。
■术后进展顺利，这个UTx导致了一个健康的婴儿的分娩。
■据我们所知，这是第一个成功的抢救技术，用于恢复静脉流出和保存移植子宫的活力和功能。我们证明，从死者供体移植的子宫有单侧流出，可以成功怀孕和分娩健康的婴儿。
■病例报告。
■医院。
■我们在此报告了一种技术，该技术用于一名30岁先天性子宫缺失的女性，该女性在脑死亡供体的UTx术后发生术中血栓形成。
■UTx是通过双侧供体髂内血管（动脉和静脉）与受体的髂外血管端对侧吻合，对移植物进行血管重建。子宫上静脉未吻合，未重建。对受体的阴道吻合术进行端到端移植。子宫再灌注后,注意到器官充血，并发现移植物髂内静脉双侧静脉血栓形成。血栓切除术后，使用“Y形”静脉跳跃移植物恢复左上子宫静脉和移植物内静脉的静脉流出。
■术中双侧静脉血栓形成后子宫移植物的活力和功能。
■术后进展顺利，这个UTx导致了一个健康的婴儿的分娩。
■据我们所知，这是第一个成功的抢救技术，用于恢复静脉流出和保存移植子宫的活力和功能。我们证明，从死者供体移植的子宫有单侧流出，可以成功怀孕和分娩健康的婴儿。
