Page 25 - Plasticos-Vol-3

V O L 3 2019 I S S U E

Postoperative

Both the donor and recipient were shifted The second patient became pregnant and
to isolation intensive care unit for better delivered a healthy baby girl on 18th October
monitoring and reverse barrier nursing was 2018 by caesarean section and the seemingly
provided. The donors were shifted to the impossible was achieved.
ward after 24 hrs and their hospital stay was
uneventful.

Recipient Conclusion

Patient was started on immunosuppressants. A total of 6 uterine transplants have been
Oral immunosuppression by mycophenolate carried out by the team till date. Our technique
mofetil, prednisolone and tacrolimus was has evolved with
started after 12 hours (Prednisolone at 20 mg/ each case and a lot
day and mycophenolate mofetil at 720mg of intraoperative
twice a day). Monitoring of tacrolimus levels impr o visation
was done every third day to keep the levels has taken place.
between 10 and 15 ng/mL for the first month Now we prefer
and between 5 to 10 ng/mL thereafter. doing end to
end anastomosis
Visual inspection of the cervix was done on day of donor and
3-it appeared red and healthy. Hysteroscopy recipient internal
guided cervical biopsy was taken on day 4 to illiac artery
rule out any signs of rejection. Daily ultrasound and vein. The
and doppler for flow in the uterine artery were establishment of
checked for a week and alternate day after that utero-ovarian axis for blood flow has allowed
till discharge. The first patient attained her some versatility choosing the vessels for
menarche at 34 days and the second patient anastomosis.
had her first menses at 48 days. By now we The tireless efforts of the postoperative team
knew that the surgery was a operative success, are going on to ensure pregnancy in the other
but real success was still far away. Close recipients as well....
monitoring by the Post-Op team with titration
of the immunosuppressive drugs was done.

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The team involved in the transplant