Omer Ozkan, M. D. , Munire Erman Akar, M. D. , Ozlenen Ozkan, M. D

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Presentation transcript:

Preliminary results of the first human uterus transplantation from a multiorgan donor Omer Ozkan, M.D., Munire Erman Akar, M.D., Ozlenen Ozkan, M.D., Okan Erdogan, M.D., Necmiye Hadimioglu, M.D., Murat Yilmaz, M.D., Filiz Gunseren, M.D., Mehmet Cincik, M.D., Elif Pestereli, M.D., Huseyin Kocak, M.D., Derya Mutlu, M.D., Ayhan Dinckan, M.D., Omer Gecici, M.D., Gamze Bektas, M.D., Gultekin Suleymanlar, M.D. Fertility and Sterility Volume 99, Issue 2, Pages 470-476.e5 (February 2013) DOI: 10.1016/j.fertnstert.2012.09.035 Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 1 The donor uterus with its vasculature and peritoneum following recovery and perfusion. BP, bladder peritoneum; LFT, left fallopian tube; LHAV, left hypogastric artery and vein; LOAV, left ovarian artery and vein; RFT, right fallopian tube; ROAV, right ovarian artery and vein; RHAV, right hypogastric artery and vein; U, uterus; V, vagina. Fertility and Sterility 2013 99, 470-476.e5DOI: (10.1016/j.fertnstert.2012.09.035) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Schematic representation of the surgical procedure. EIA: recipient external iliac artery; EIV: recipient external iliac vein; HA: donor hypogastric artery; HV: donor hypogastric vein; O: recipient ovary; U: donor uterus; V/V: recipient and donor vaginas. Note bilateral salpingeal tubes were ligated. Fertility and Sterility 2013 99, 470-476.e5DOI: (10.1016/j.fertnstert.2012.09.035) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Three-dimensional ultrasonographic appearance of the transplanted uterus and endometrium at 5 months after transplantation. Fertility and Sterility 2013 99, 470-476.e5DOI: (10.1016/j.fertnstert.2012.09.035) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 4 Uterine artery blood flow at 7 months after transplantation. Fertility and Sterility 2013 99, 470-476.e5DOI: (10.1016/j.fertnstert.2012.09.035) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Supplemental Figure 1 View of the transplanted cervix at 11 months after transplantation. Fertility and Sterility 2013 99, 470-476.e5DOI: (10.1016/j.fertnstert.2012.09.035) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Supplemental Figure 2 Pathologic aspects of the vaginal mucosa specimen showing CD4 lymphocytes at 6 months after transplantation (arrow shows CD4 lymphocytes). Fertility and Sterility 2013 99, 470-476.e5DOI: (10.1016/j.fertnstert.2012.09.035) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Supplemental Figure 3 Pathologic aspects of the endometrium showing vacuolization of the glandular epithelium and edematous stroma at 6 months after transplantation. Fertility and Sterility 2013 99, 470-476.e5DOI: (10.1016/j.fertnstert.2012.09.035) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Supplemental Figure 4 Diagram of the luteinizing hormone (LH) and follicle-stimulating hormone (FSH) changes during menstrual cycles after transplantation. (*Denotes first day of menstrual cycle.) Fertility and Sterility 2013 99, 470-476.e5DOI: (10.1016/j.fertnstert.2012.09.035) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Supplemental Figure 5 Diagram of the estradiol (E2) changes during menstrual cycles posttransplantation. (*Denotes first day of menstrual cycle.) Fertility and Sterility 2013 99, 470-476.e5DOI: (10.1016/j.fertnstert.2012.09.035) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions