Krishen Sieunarine

Human uterus retrieval from a multi-organ donor

OBJECTIVE: To determine if a uterus can be retrieved for reproductive organ transplantation and to describe the surgical technique. METHODS: We participated in a local organ donor network retrieval team for over 6 months. Heart-beating, brain-dead multi-organ donors were identified through an existing donor network following routine protocols. RESULTS: After institutional review board and organ donor network approval of the uterus transplantation project, approximately 1,800 eligible organ donors were identified as required by legislation. Multi-organ procurement surgery took place in approximate 150 of these, with nine specifically consented for the uterus retrieval. Regularly performed multi-organ transplantation retrievals included the uterus without complications in eight donors. Pedicles used included the ovarian, uterine, or internal iliac vessels. After retrieval, serial histology sections throughout the period of cold ischemia, taken every 15–30 minutes, showed no signs of change over 12 hours of cold ischemia. CONCLUSION: The human uterus can be obtained from local organ donor networks using existing protocols. LEVEL OF EVIDENCE: III

Conservative surgical management of ruptured interstitial pregnancy

material used for promontofixation (5). Mesh exposure was probably favored by an incorrect placement of the tape (inversion). The tape route in contact with obturator externus muscle explains the infectious extension to the psoas and the thigh muscle compartments. The thigh muscle compartments, iliac and psoas muscles are close to the obturator muscle and the infectious process diffuses gradually. Subsequently, it was considered that it would have been preferable to have entirely removed the tape during the first surgery. Infectious complications exist with the transobturator tape procedure. Muscle compartments in proximity are at high risk of infection. This fact explains the severity of the case reported.