Name: surgical approach, challenges, and resolutions for uterus transplantation in rats
Uploaded: 2023-04-14T14:00:00
Description: Watch this Scientific Journal Video about Surgical Approach, Challenges, and Resolutions for Uterus Transplantation in Rats at JoVE.com

这项研究得到了瑞士国家科学基金会的支持（项目资助号：310030_192736）。我们要感谢苏黎世大学兽医病理学研究所的Frauke Seehusen博士在组织病理学方面的支持。

所有动物实验均按照瑞士联邦动物法规进行，并经苏黎世兽医局批准（n° 225/2019），确保人类护理。雌性处女刘易斯大鼠（体重170-200克）和雌性处女布朗挪威大鼠（170-200克）被用作子宫供体/受体，而雄性刘易斯大鼠（300-320克）用于交配。大鼠的年龄为12-15个月。这些动物是从商业来源获得的（见 材料表），并被饲养在受控条件和丰富的环境中，可以自由获得水和标准食物。
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<ol>
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P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Options+for+acquiring+motherhood+in+absolute+uterine+factor+infertility;+adoption,+surrogacy+and+uterine+transplantation.">Options for acquiring motherhood in absolute uterine factor infertility; adoption, surrogacy and uterine transplantation.</a> The Obstetrician &amp; Gynaecologist. 23 (2), 138-147 (2021).</li><li>Brannstrom, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+first+clinical+trial+of+uterus+transplantation:+surgical+technique+and+outcome.">The first clinical trial of uterus transplantation: surgical technique and outcome.</a> American Journal of Transplantation. 14, 44 (2014).</li><li>Ejzenberg, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Livebirth+after+uterus+transplantation+from+a+deceased+donor+in+a+recipient+with+uterine+infertility.">Livebirth after uterus transplantation from a deceased donor in a recipient with uterine infertility.</a> Lancet. 392 (10165), 2697-2704 (2018).</li><li>Lavoue, V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Which+donor+for+uterus+transplants:+brain-dead+donor+or+living+donor?+A+systematic+review.">Which donor for uterus transplants: brain-dead donor or living donor? A systematic review.</a> Transplantation. 101 (2), 267-273 (2017).</li><li>O'Donovan, L., Williams, N. J., Wilkinson, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ethical+and+policy+issues+raised+by+uterus+transplants.">Ethical and policy issues raised by uterus transplants.</a> British Medical Bulletin. 131 (1), 19-28 (2019).</li><li>Kisu, I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long-term+outcome+and+rejection+after+allogeneic+uterus+transplantation+in+cynomolgus+macaques.">Long-term outcome and rejection after allogeneic uterus transplantation in cynomolgus macaques.</a> Journal of Clinical Medicine. 8 (10), 1572 (2019).</li><li>Ozkan, O., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Uterus+transplantation:+From+animal+models+through+the+first+heart+beating+pregnancy+to+the+first+human+live+birth.">Uterus transplantation: From animal models through the first heart beating pregnancy to the first human live birth.</a> Womens Health. 12 (4), 442-449 (2016).</li><li>Favre-Inhofer, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Involving+animal+models+in+uterine+transplantation.">Involving animal models in uterine transplantation.</a> Frontiers in Surgery. 9, 830826 (2022).</li><li>El-Akouri, R. R., Wranning, C. A., Molne, J., Kurlberg, G., Brannstrom, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pregnancy+in+transplanted+mouse+uterus+after+long-term+cold+ischaemic+preservation.">Pregnancy in transplanted mouse uterus after long-term cold ischaemic preservation.</a> Human Reproduction. 18 (10), 2024-2030 (2003).</li><li>Sahin, S., Selcuk, S., Eroglu, M., Karateke, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Uterus+transplantation:+Experimental+animal+models+and+recent+experience+in+humans.">Uterus transplantation: Experimental animal models and recent experience in humans.</a> Turkish Journal of Obstetrics and Gynecology. 12 (1), 38-42 (2015).</li><li>Wranning, C. A., Akhi, S. N., Diaz-Garcia, C., Brannstrom, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pregnancy+after+syngeneic+uterus+transplantation+and+spontaneous+mating+in+the+rat.">Pregnancy after syngeneic uterus transplantation and spontaneous mating in the rat.</a> Human Reproduction. 26 (3), 553-558 (2011).</li><li>Wranning, C. A., Akhi, S. N., Kurlberg, G., Brannstrom, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Uterus+transplantation+in+the+rat:+Model+development,+surgical+learning+and+morphological+evaluation+of+healing.">Uterus transplantation in the rat: Model development, surgical learning and morphological evaluation of healing.</a> Acta Obstetricia et Gynecologica Scandinavica. 87 (11), 1239-1247 (2008).</li><li>Brannstrom, M., Wranning, C. A., Altchek, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Experimental+uterus+transplantation.">Experimental uterus transplantation.</a> Human Reproduction Update. 16 (3), 329-345 (2010).</li><li>Diaz-Garcia, C., Akhi, S. N., Wallin, A., Pellicer, A., Brannstrom, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=First+report+on+fertility+after+allogeneic+uterus+transplantation.">First report on fertility after allogeneic uterus transplantation.</a> Acta Obstetricia et Gynecologica Scandinavica. 89 (11), 1491-1494 (2010).</li><li>R, E., Brown, M. J., Karas, A. Z. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Anesthesia and Analgesia in Laboratory Animals. 2nd edn. , (2008).</li><li>Donovan, J., Brown, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Euthanasia.">Euthanasia.</a> Current Protocols. , 8 (2006).</li><li>Rutledge, C., Raper, D. M. S., Abla, A. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=How+I+do+it:+superficial+temporal+artery-middle+cerebral+artery+bypass+for+flow+augmentation+and+replacement.">How I do it: superficial temporal artery-middle cerebral artery bypass for flow augmentation and replacement.</a> Acta Neurochirurgica. 162 (8), 1847-1851 (2020).</li><li>Kuo, S. C. -. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+multiple-U+technique:+a+novel+microvascular+anastomosis+technique+that+guarantees+everted+anastomosis+sites+with+solid+intima-to-intima+contact.">The multiple-U technique: a novel microvascular anastomosis technique that guarantees everted anastomosis sites with solid intima-to-intima contact.</a> Plastic and Reconstructive Surgery. 149 (5), 981 (2022).</li><li>Magee, D. J., Manske, R. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Pathology and Intervention in Musculoskeletal Rehabilitation. 2nd edn. , 25-62 (2016).</li><li>Diaz-Garcia, C., Johannesson, L., Shao, R. J., Bilig, H., Brannstrom, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pregnancy+after+allogeneic+uterus+transplantation+in+the+rat:+perinatal+outcome+and+growth+trajectory.">Pregnancy after allogeneic uterus transplantation in the rat: perinatal outcome and growth trajectory.</a> Fertility and Sterility. 102 (6), 1545-1552 (2014).</li><li>Canovai, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=IGL-1+as+a+preservation+solution+in+intestinal+transplantation:+a+multicenter+experience.">IGL-1 as a preservation solution in intestinal transplantation: a multicenter experience.</a> Transplant International. 33 (8), 963-965 (2020).</li><li>Habran, M., De Beule, J., Jochmans, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=IGL-1+preservation+solution+in+kidney+and+pancreas+transplantation:+A+systematic+review.">IGL-1 preservation solution in kidney and pancreas transplantation: A systematic review.</a> PLoS One. 15 (4), 0231019 (2020).</li><li>Mosbah, I. B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=IGL-1+solution+reduces+endoplasmic+reticulum+stress+and+apoptosis+in+rat+liver+transplantation.">IGL-1 solution reduces endoplasmic reticulum stress and apoptosis in rat liver transplantation.</a> Cell Death &amp; Disease. 3 (3), 279 (2012).</li><li>Wiederkehr, J. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Use+of+IGL-1+preservation+solution+in+liver+transplantation.">Use of IGL-1 preservation solution in liver transplantation.</a> Transplantation Proceedings. 46 (6), 1809-1811 (2014).</li><li>Tilney, N. L., Guttmann, R. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+initial+ischemia/reperfusion+injury+on+the+transplanted+kidney.">Effects of initial ischemia/reperfusion injury on the transplanted kidney.</a> Transplantation. 64 (7), 945-947 (1997).</li><li>de Rougemont, O., Dutkowski, P., Clavien, P. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Biological+modulation+of+liver+ischemia-reperfusion+injury.">Biological modulation of liver ischemia-reperfusion injury.</a> Current Opinion in Organ Transplantation. 15 (2), 183-189 (2010).</li><li>Jakubauskiene, L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Relaxin+and+erythropoietin+significantly+reduce+uterine+tissue+damage+during+experimental+ischemia-reperfusion+injury.">Relaxin and erythropoietin significantly reduce uterine tissue damage during experimental ischemia-reperfusion injury.</a> International Journal of Molecular Sciences. 23 (13), 7120 (2022).</li><li>Wang, Y., Wu, Y., Peng, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Resveratrol+inhibits+the+inflammatory+response+and+oxidative+stress+induced+by+uterine+ischemia+reperfusion+injury+by+activating+PI3K-AKT+pathway.">Resveratrol inhibits the inflammatory response and oxidative stress induced by uterine ischemia reperfusion injury by activating PI3K-AKT pathway.</a> PLoS One. 17 (6), 0266961 (2022).</li><li>Kisu, I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Risks+for+donors+in+uterus+transplantation.">Risks for donors in uterus transplantation.</a> Reproductive Sciences. 20 (12), 1406-1415 (2013).</li><li>Jones, B. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Uterine+transplantation+in+transgender+women.">Uterine transplantation in transgender women.</a> BJOG: an International Journal of Obstetrics and Gynaecology. 126 (2), 152-156 (2019).</li></ol>

这里介绍的方案为大鼠子宫移植背后的手术方法提供了详细说明。该协议已经过优化，以增加UTx和随后交配后活产的几率。原始协议已从Brännström组12，13中接管，灵感来自Akouri等人10的小鼠工作，并根据作者过去几年的经验进行了修改。因此，这些修改是由真实的学习曲线驱动的，反映了从失败的移植到可重复结果的发展。
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子宫移植（UTx）是绝对子宫因子不孕症（AUFI）的新疗法。AUFI由子宫缺失（先天性或后天性）或畸形引起，影响全球3%-5%的女性1。道德、法律或宗教原因排除了许多渴望成为母亲但患有AUFI2的女性的收养或代孕。对于这些女性来说，UTx仍然是组建自己家庭的唯一选择。UTx已被应用于临床，尽管成功与否参差不齐;该程序在技术上具有挑战性，需要稳步改进其临床建立。
2014年，瑞典先驱小组Brännström3进行了首次活体供体（LD）子宫移植手术，成功怀孕。2016 年，巴西报告了来自已故供体 （DD） 的 UTx 后的首次分娩4.到 2021 年，全球已进行了 80 多次 UTx，但成功率约为 50%，大多数来自 LD 的移植物1.
虽然不能挽救生命，但UTx是一种越来越受欢迎的程序，可以满足对自己后代的愿望。因此，对移植物的需求正在增加，将DD捐赠置于未来的重点。然而，由于长时间的冷（在心脏死亡的情况下，也是温暖的）缺血暴露，DD捐赠很复杂，增加了移植功能障碍和排斥的风险5，6。手术技术、苛刻的相容性匹配和相关免疫抑制仍然是关于UTx结果的关键问题7。
为了在临床上管理上述风险，需要适当的动物模型来探索缺血和免疫抑制。动物模型最具临床相关性的终点仍然是成功分娩;迄今为止，实验性UTx后的妊娠已在小鼠，大鼠，绵羊，兔子和食蟹猴中实现8。虽然较大的动物注定要获得和优化手术技术，但啮齿动物具有妊娠期短的明显优势。因此，啮齿动物模型在实际、财务和道德考虑方面更胜一筹9.然而，UTx在小鼠中的主要挑战是小解剖结构，高要求的手术与小鼠UTx 10的低重现性有关。相比之下，大鼠在手术上更容易获得，并保留了妊娠时间短的优点。因此，大鼠已成为UTx 9的首选模型。Wranning等人在2008年引入了原位UTx的大鼠模型，使用该模型，已经报道了UTx和自然交配后的首次活产11，12，13。随后的研究对UTx在人类中的实施做出了重要贡献9。
尽管如此，UTx在大鼠中仍然具有挑战性，到目前为止，只有少数一组掌握了这种手术技术。大鼠UTx在研究人员中传播的一个相关障碍是缺乏对单个显微外科步骤，陷阱以及故障排除的相应措施的精确描述14。该协议旨在为这种高度复杂的显微外科手术提供详细的指南，以促进该动物模型在未来研究中的实施。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>Angled to Side Scissor 5 mm</td>
			<td>F.S.T</td>
			<td>15008-08</td>
			<td></td>
		</tr>
		<tr>
			<td>Big Paper Clip</td>
			<td>No specific</td>
			<td></td>
			<td>Used as retractor</td>
		</tr>
		<tr>
			<td>Blunt Bend Needle G30</td>
			<td>Unimed S.A.</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Bupivacain 0.5%</td>
			<td>Sintetica</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Buprenorphine 0.3 mg/mL</td>
			<td>Temgesic</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Dosiernadel G25</td>
			<td>H.SIGRIST&#38; PARTNER AG</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Dumont #5SF Forceps</td>
			<td>F.S.T</td>
			<td>11252-00</td>
			<td></td>
		</tr>
		<tr>
			<td>Ethilon 10/0</td>
			<td>Ethicon</td>
			<td>2810G</td>
			<td></td>
		</tr>
		<tr>
			<td>Ethilon 6/0</td>
			<td>Ethicon</td>
			<td>667H</td>
			<td></td>
		</tr>
		<tr>
			<td>Ethilon 7/0</td>
			<td>Ethicon</td>
			<td>EH7446H</td>
			<td></td>
		</tr>
		<tr>
			<td>Ethilon 8/0</td>
			<td>Ethicon</td>
			<td>2808G</td>
			<td></td>
		</tr>
		<tr>
			<td>Femal Brown Norway Rats (150-170 g)</td>
			<td>Janvier</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Femal Lewis Rats (150-170 g)</td>
			<td>Charles River Deutschland</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Fine Scissors - Sharp</td>
			<td>F.S.T</td>
			<td>14060-09</td>
			<td>Any other small scissor works too</td>
		</tr>
		<tr>
			<td>Halsey Micro Needle Holder</td>
			<td>F.S.T</td>
			<td>12500-12</td>
			<td>Any other small needholder works too</td>
		</tr>
		<tr>
			<td>Heparin Natrium 25000 I.E./ 5 mL</td>
			<td>B. Braun</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Institute Georges Lopez Perfusion Solution (IGL)</td>
			<td>Institute Georges Lopez</td>
			<td></td>
			<td>Organ preservation solution&#160;&#160;</td>
		</tr>
		<tr>
			<td>Male Lewis Rats (300-320 g)</td>
			<td>Charles River Deutschland</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Micro Serrefines 13 mm</td>
			<td>F.S.T</td>
			<td>18055-04&#160;&#160;</td>
			<td></td>
		</tr>
		<tr>
			<td>Micro Serrefines 16 mm gebogen</td>
			<td>F.S.T</td>
			<td>18055-06</td>
			<td></td>
		</tr>
		<tr>
			<td>Micro-Serrefine Clamp Applicator with Lock&#160;&#160;</td>
			<td>F.S.T</td>
			<td>18056-14&#160;&#160;</td>
			<td></td>
		</tr>
		<tr>
			<td>M&#246;lnlyncke Op Towel</td>
			<td>M&#246;lnlyncke</td>
			<td>800300</td>
			<td>Sterile drape</td>
		</tr>
		<tr>
			<td>NaCl 0.9%</td>
			<td>B.Braun</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Octenisept</td>
			<td>Sch&#252;lke</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Paper Tape</td>
			<td>Tesa</td>
			<td></td>
			<td>For fixing the animal</td>
		</tr>
		<tr>
			<td>Philips Avent Schneller Flaschenw&#228;rmer SCF358/02</td>
			<td>Philips</td>
			<td>12824216</td>
			<td></td>
		</tr>
		<tr>
			<td>Ringerfundin</td>
			<td>B.Braun</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Rompun 2%</td>
			<td>Bayer</td>
			<td></td>
			<td>Xylazine</td>
		</tr>
		<tr>
			<td>Round Handled Needle Holders</td>
			<td>F.S.T</td>
			<td>12075-12</td>
			<td></td>
		</tr>
		<tr>
			<td>Round Handled Needle Holders</td>
			<td>F.S.T</td>
			<td>12075-12</td>
			<td></td>
		</tr>
		<tr>
			<td>S&#38;T Vessel Dilating Forceps - Angled 45&#176;</td>
			<td>F.S.T</td>
			<td>00276-13</td>
			<td></td>
		</tr>
		<tr>
			<td>Sacryl Naht</td>
			<td>KRUUSE</td>
			<td>152575</td>
			<td></td>
		</tr>
		<tr>
			<td>Scapel No 10</td>
			<td>Swann Morton</td>
			<td>201</td>
			<td></td>
		</tr>
		<tr>
			<td>Small Histo-Container</td>
			<td></td>
			<td></td>
			<td>Any small histo-container works fine-for coldstorage of the graft</td>
		</tr>
		<tr>
			<td>Small Plastik Bags</td>
			<td></td>
			<td></td>
			<td>Any transparant plastic bags are fine</td>
		</tr>
		<tr>
			<td>Steril Cotton swab</td>
			<td>Lohmann-Rauscher</td>
			<td></td>
			<td>Any steril cotton swab is fine</td>
		</tr>
		<tr>
			<td>Sterile Gauze</td>
			<td>Lohmann-Rauscher</td>
			<td></td>
			<td>Any steril gauze is fine</td>
		</tr>
		<tr>
			<td>Straight Scissor 8mm</td>
			<td>F.S.T</td>
			<td>15024-10</td>
			<td></td>
		</tr>
		<tr>
			<td>Surgical microscope &#8211; SZX9</td>
			<td>Olympus</td>
			<td>OLY-SZX9-B</td>
			<td></td>
		</tr>
		<tr>
			<td>Sutter Non Stick GLISS 0.4 mm</td>
			<td>Sutter</td>
			<td>78 01 69 SLS</td>
			<td></td>
		</tr>
		<tr>
			<td>Suture Tying Forceps&#160;</td>
			<td>F.S.T</td>
			<td>00272-13</td>
			<td></td>
		</tr>
		<tr>
			<td>ThermoLux warming mat</td>
			<td>ThermoLux</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Tissue Forceps for Skin</td>
			<td></td>
			<td></td>
			<td>Any tissue forceps are fine</td>
		</tr>
		<tr>
			<td>Vesseldilatator Forceps</td>
			<td>F.S.T</td>
			<td>00125-11</td>
			<td></td>
		</tr>
		<tr>
			<td>Vicryl&#160; plus 4/0</td>
			<td>Ethicon</td>
			<td>VCP292H</td>
			<td></td>
		</tr>
	</tbody>
</table>

surgical approach, challenges, and resolutions for uterus transplantation in rats

子宫移植（UTx）是一种治疗绝对子宫因子不孕症（AUFI）女性的新方法。估计有3%-5%的女性患有AUFI。这些妇女被剥夺了生育的选择，直到UTx出现。UTx的临床应用是由动物实验研究推动的，第一次成功的UTx是在大鼠身上实现的。鉴于其生理，免疫，遗传和生殖特征，大鼠是此类移植的合适模型系统。特别是，它们的妊娠期短是一个明显的优势，因为实验性UTx的通常终点是活产成功怀孕。大鼠模型面临的最大挑战仍然是小解剖结构，这需要先进的显微外科技能和经验。尽管UTx在临床上导致怀孕，但该程序尚未建立，需要不断的实验优化。在这里，提出了一个详细的协议，包括大鼠UTx的基本故障排除，预计这将使那些没有这种显微手术经验的人更容易掌握整个过程。

介绍两组大鼠的结果。UTx在（组1，n = 8）和之后（组2，n = 8）协议调整（表1）之前进行，以证明我们修改的效果（请参阅讨论以了解我们的修改解释）12，15，21。
大鼠UTx的结果与三个关键阶段有关。第一阶段是从 UTx 成功恢复。通常，接受者应在术后前 2 天内恢复。第二阶段涉及...

Watch this Scientific Journal Video about Surgical Approach, Challenges, and Resolutions for Uterus Transplantation in Rats at JoVE.com

Surgical Approach, Challenges, and Resolutions for Uterus Transplantation in Rats

本协议描述了大鼠成功子宫移植（UTx）的所有基本步骤。该大鼠模型已被证明适合促进UTx的临床实施;然而，大鼠UTx是一个高度复杂的过程，需要仔细的指示。

大鼠子宫移植的手术方法、挑战和解决方案

Uterine transplantation (UTx) is a new approach for treating women with absolute uterine factor infertility (AUFI). An estimated 3%-5% of women suffer ...

右子宫移植属于只有少数人掌握的最复杂的显微外科手术之一。我们的方案将右子宫移植从实验阶段转移到适用的方法。我们的方案导致子宫移植后的活产率很高。它将很快促进右子宫移植在实际研究中的应用。耐心和耐力是整个过程的关键特征。进行正中剖腹手术后，在麻醉的大鼠上，收获带有子宫总腔和子宫颈以及血管椎弓根的右子宫角。烧灼伤口并用4-0聚半乳糖素缝合线连接左子宫角。现在切断与子宫总腔分支相邻的左子宫角。将未来移植物的宫颈和阴道部分与直肠附件分开。将未来的移植物与阴道旁和宫颈旁韧带分开。使用透热疗法，在子宫颈尾部约两到三毫米处解剖阴道。在子宫动脉和静脉的起源处找到子宫动脉和静脉。用8-0结扎子宫血管尾部的所有血管聚酰胺地方。第8-0名聚酰胺结扎直接围绕右髂总动脉和靠近主动脉和腔分叉的静脉。在与分叉直接相邻的右髂总动脉上做一个 0.5 到 1 毫米长的切口。将一根钝的 25 号直针插入管腔以将其冲洗掉。用 6-0 聚酰胺结扎固定针头。为了在冲洗过程中能够流出，请将髂总静脉尾部解剖到右髂总静脉的结扎处。使用三毫升注射器，用冷林格氏溶液冲洗子宫，然后补充有肝素和甲苯噻嗪的器官保存溶液。在腹主动脉分叉处切开结扎的髂总动脉尾部。然后使用钝性夹层，在子宫血管分裂处切断主动脉腔静脉分叉处的髂总血管。并在子宫组织变白时取出移植物。将移植物放入冷器官保存溶液中，以方便移植前的背台准备和储存。将移植物放入腹腔并定位移植静脉后，将一条 10-0 聚酰胺保持缝合线插入颅角，将一根松散的缝合线插入右髂总静脉裂缝的尾角。使用六到八圈连续缝合将移植静脉的一侧吻合到受体的静脉中。同样，从外部吻合血管的另一侧。然后使用10-0聚酰胺，在颅骨缝合处打一个结，在尾部保持缝合处打另一个结。在右侧髂总动脉处使用 10-0 聚酰胺中断缝合线进行动脉吻合，有 8 到 10 个环。要开始移植物灌注，当部位出现未通畅时，松开移植物血管上的血管夹，并检查移植物是否有再灌注的迹象。使用六到七个6-0聚半乳糖蛋白中断缝合线将移植的阴道袖带连接到阴道穹窿。使用5-7条聚酰胺7-0中断缝合线，将图子宫角端对端吻合到剩余的受体颅子宫段。监测大鼠柱操作。子宫移植后，两只第1组大鼠表现出怀孕迹象。然而，检查显示子宫扩张，表明幼崽发育正常，但大鼠未能分娩幼崽。胎儿的组织学检查显示，幼崽发育到分娩。5只第2组大鼠表现出怀孕，其中3只生下幼崽。刘易斯雌性生了两次。第一窝的所有幼崽都存活了下来，而第二窝的三只幼崽中只有两只幸存下来。棕色的挪威雌性也生了两次，所有幸存的幼崽都表现出正常的发育。方案调整改善了直接手术结局和子宫移植后的活产率。它将两周移植物存活率从第1组的50%提高到第2组的75%。重要的是保持尾角的缝合结松散，以便更好地调整并防止噘起的绳子效应。右子宫移植特别适合评估可能改善子宫移植结局的移植前方法，例如离体皮下器官灌注或其他减轻器官损伤的技术。一般来说，动物子宫移植在临床上已经并且是建立子宫移植的必须引入的。

Research

JoVE Journal

Medicine

Orthotopic Small Bowel Transplantation in Rats

大鼠原位小肠移植

Small  bowel transplantation has become an accepted clinical option for patients with  short gut syndrome and failure of parenteral nutrition ...

科研

医学

Orthotopic Liver Transplantation in Rats

大鼠原位肝移植

Clinical progress in the field of liver transplantation has been largely supported by animal models1,2. Since the publication of the first orthotopic rat ...

A Novel Surgical Approach for Intratracheal Administration of Bioactive Agents in a Fetal Mouse Model

一种新的手术方法气管内注射生物活性剂在胎鼠模型

Prenatal pulmonary delivery of cells, genes or pharmacologic agents could provide the basis for new therapeutic strategies for a variety of genetic and ...

Surgical Procedures for a Rat Model of Partial Orthotopic Liver Transplantation with Hepatic Arterial Reconstruction

部分原位肝移植大鼠模型的肝动脉重建的外科手术

Orthotopic liver transplantation (OLT) in rats using a whole or partial graft is an indispensable experimental model for transplantation research, such as ...

Transplantation of Pulmonary Valve Using a Mouse Model of Heterotopic Heart Transplantation

肺动脉瓣使用异位心脏移植小鼠模型移植

Tissue engineered heart valves, especially decellularized valves, are starting to gain momentum in clinical use of reconstructive surgery with mixed ...

Ex Situ Normothermic Machine Perfusion of Donor Livers

Ex Situ Normothermic Machine Perfusion of Donor Livers

供肝易地常温灌注机

In contrast to conventional static cold preservation (0-4 &#176;C), ex situ machine perfusion may provide better preservation of donor livers. Continuous ...

The Mouse Round-window Approach for Ototoxic Agent Delivery: A Rapid and Reliable Technique for Inducing Cochlear Cell Degeneration

老鼠圆窗途径耳毒性剂递送：一个快速和可靠的技术诱导耳蜗细胞变性

Investigators have utilized a wide array of animal models and investigative techniques to study the mammalian auditory system. Much of the basic research ...

Surgical Approach for Middle Cerebral Artery Occlusion and Reperfusion Induced Stroke in Mice

对大脑中动脉闭塞再灌注损伤诱发中风小鼠的手术方法

Stroke is a leading cause of death worldwide and continues to be one of the major causes of long-term adult disabilities. About 87% of strokes are ...

A Rat Model of Orthotopic Liver Transplantation Using a Novel Magnetic Anastomosis Technique for Suprahepatic Vena Cava Reconstruction

应用新型磁吻合技术 Suprahepatic 腔静脉重建大鼠原位肝移植模型的研究

The rat model of orthotopic liver transplantation (OLT) is essential for transplant research. It is a very sophisticated animal model and requires a steep ...

Designing CAD/CAM Surgical Guides for Maxillary Reconstruction Using an In-house Approach

用内部方法设计上颌重建的 cad/cam 手术指南

Computer-aided design/computer-assisted manufacturing (CAD/CAM) is now being evaluated as a preparative technique for maxillofacial surgery. Because this ...