Analysis of Predictive Factors for Successful Vascular Anastomoses in a Sheep Uterine Transplantation Model - Archive ouverte HAL Access content directly
Journal Articles Journal of Clinical Medicine Year : 2022

Analysis of Predictive Factors for Successful Vascular Anastomoses in a Sheep Uterine Transplantation Model

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Abstract

Uterine transplantation is becoming an increasingly realistic therapeutic for uterine infertility. Surgical training on large animal models such as sheep is a prerequisite for establishing a program in humans. The objective of our study was to analyze the predictive factors for successful vascular anastomoses. We performed 40 autotransplants that involved end-to-side anastomoses from the uterine to the external iliac vessels. We analyzed vessel results in terms of success or failure; a total of 78.7% of arterial and 82.9% of venous anastomoses were successful in the immediate postoperative period. In multivariate analysis, independent factors associated with immediate successful vein anastomoses were as follows: a short warm ischemia time (<2 h, OR = 0.05; 95% CI [0.003–0.88], p = 0.04 ), the absence of any anastomotic complications (OR = 0.06; 95% CI [0.003–0.099], p = 0.049), and their realization by a vascular surgeon (OR = 29.3; 95% CI [1.17–731.9], p = 0.04 ). Secondly, we showed that an increase in lactate levels greater than 2.72 mmol/L, six hours after reperfusion was predictive of failure, with a sensibility of 85.7% and a specificity of 75.0%. In order to perfect the management of vascular anastomoses by a vascular surgeon, training on animal models and in microsurgery are mandatory in establishing a uterine transplantation program in humans
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Dates and versions

hal-03770597 , version 1 (06-09-2022)

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Claire Le Gal, Marie Carbonnel, Vincent Balaya, Christophe Richard, Valerie Gelin, et al.. Analysis of Predictive Factors for Successful Vascular Anastomoses in a Sheep Uterine Transplantation Model. Journal of Clinical Medicine, 2022, 11, pp.5262. ⟨10.3390/jcm11185262⟩. ⟨hal-03770597⟩
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