Uterus retrieval process from brain dead donors

Abstract

Objective: To describe the feasibility of human uterus retrieval after donation after brain death.

Design: Single-center, prospective study.

Setting: University hospital.

Patient(s): Female brain dead donors.

Intervention(s): The families of female brain dead donors were informed about consent to uterus donation. A specific organ retrieval procedure was performed. At the end of the procedure the uterus was removed together with the hypogastric vessels, parametria, and vaginal fornix. The tolerance of the uterus to cold ischemia was evaluated with histology and TUNEL reaction up to 24 hours.

Main outcome measure(s): Rate of uterus donation refusal.

Result(s): Between August 1, 2012 and July 31, 2013, seven uteri were retrieved from 14 female multiorgan donors. No refusal to uterus donation occurred. Our surgical protocol did not interfere with vital organ retrieval and was readily accepted by the other transplantation teams. The hypogastric vessels could be preserved in all cases but for one vein loss in the first retrieval. Histology studies did not find major morphologic changes after 24 hours of cold ischemia. Apoptosis was rare.

Conclusion(s): Uterus retrieval could be part of a reproducible multiorgan procurement procedure. Uterus donation seems readily accepted. This preliminary study is a necessary step before any transplantation project.

Keywords: Uterus; brain dead donor; donation after brain death (DBD); fertility; surgery; transplantation.