猕猴异体子宫移植技术的应用研究

目的探讨猕猴异体子宫移植活体捐赠手术技巧应用,为下一步人体子宫移植临床试验提供实验数据。方法选用性成熟、月经规律的雌性猕猴2只,根据血型和体重选取供体1例和受体1例,将切除的供体子宫及髂血管给予器官保存液冷保存、灌注后原位移植到受体盆腔,供体的髂内动脉、髂外静脉与受体的髂外动、静脉使用端-侧吻合法间断吻合,术中根据移植血管的搏动、子宫的色泽判断移植是否成功,术后给予他克莫司、环孢霉素、泼尼松三联免疫抑制剂预防移植免疫排斥。结果受体猕猴移植双侧髂血管吻合成功,可触及移植血管搏动,移植子宫恢复血流灌注后子宫颜色由灰白逐渐转为暗红。受体动物于子宫移植术后28d死亡,评估死亡原因可能为慢性衰竭。结论猕猴是适用于异体子宫移植研究的大型动物模型,使用髂内动脉与受体的髂外动脉进行端-侧吻合法吻合是可行的,三联免疫抑制剂可有效预防移植免疫排斥。

Application research on the technology of uterus allotransplantation in rhesus monkey

Objective:To examine application research on the technology of uterus allotransplantation in rhesus monkey,and provide clinic data for the next step human uterus allotransplantation.Methods:Two female rhesus monkeys with sexual maturity and regular menstrual cycle were used.One donor and one recipient were selected depending on their blood type and body weight.The uterus with vaginal canal and main blood vessels were removed from living donors and stored in cold preservation solution.Then the isolated organ was transplanted to the recipient after perfusion.The internal iliac artery was end-side anastomosed with external iliac arteries from the recipient animals.Whether the transplantation was successful,it was depended on the pulsation of grafts vessels,color and elastic,size,bleeding of the grafts uterus during operation.The recipient was offered tacrolimus,cyclosporine,prednisone triple immunosuppressive agents to prevent transplant immune rejection postoperative.Results:The transplantation bilateral iliac vascular anastomosis of recipient rhesus monkey was successful.The pulse of transplanted blood vessels can be touched.The transplanted uterus color was changed from grey gradually to red.The recipient animal was died due to chronic failure 28 days after surgery.Conclusions:Rhesus monkey is suitable for large animal models of allogeneic uterine transplantation.The iliac artery and external iliac artery to end-side anastomosis method is feasible,and the trigeminy immune inhibitors are effective preventing rejection.