Anorectal Transplantation in Human Cadavers Mock Anorectal Allotransplantation.docVIP

Anorectal Transplantation in Human Cadavers: Mock Anorectal Allotransplantation Jun Araki , Yuji Nishizawa , Tomoyuki Sato , Munekazu Naito , Keiichi Akita , Kensuke Tashiro , Takuya 1* 2 3 4 5 1 , Isao Koshima Iida 1 1 1 Department of Plastic Surgery, University of Tokyo, Tokyo, Japan, 2 Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan, 3 Saitama Shinkaibashi Clinic, Saitama, Japan, 4 Department of Anatomy, Tokyo Medical University, Tokyo, Japan, 5 Department of Clinical Anatomy, Tokyo Medical and Dental University, Tokyo, Japan Abstract Background: Anorectal transplantation is a method for patients who have lost their anorectal function or suffer from congenital anorectal dysfunction to recover this function, and this has been investigated in experimental animal models using pigs, dogs, and rats. In this study, we performed an examination of anorectal transplantation in human cadavers to investigate whether this procedure could be performed in patients. Methods: A 77-year-old woman cadaver 1 was used as the donor and a 98-year-old woman cadaver 2 was used as the recipient. Initially, abdominoperineal excision of the anus and rectum (the Miles’ operation) was performed on the recipient. Next, an anorectal graft containing the pudendal nerve (PN), pudendal artery (PA), pudendal vein (PV), inferior mesenteric artery (IMA), and inferior mesenteric vein (IMV) was harvested from the donor. The donor graft was transplanted into the recipient by intestinal anastomosis and microneurovascular anastomoses orthotopically. Results: The diameters of the PN (right/left), IMA, and IMV were 2.5 mm/2.5 mm, 2.0 mm, and 1.5 mm, respectively, in cadaver 1, and 2.0 mm/2