{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T22:55:05Z","timestamp":1782773705308,"version":"3.54.5"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Multivisceral transplantation of pelvic organs would be a potential treatment for severe pelvic floor dysfunction with fecal and urinary incontinence, extensive perineal trauma, or congenital disorders<jats:ext-link>.<\/jats:ext-link> Here, we describe the microsurgical technique of multivisceral transplantation of pelvic organs, including the pelvic floor, in rats.<\/jats:p><\/jats:sec><jats:sec><jats:title>Donor operation<\/jats:title><jats:p>We performed a perineal (including the genitalia, anus, muscles, and ligaments) and abdominal incision. The dissection progressed near the pelvic ring, dividing ligaments, muscles, external iliac vessels, and pudendal nerves, allowing pelvic floor mobilization. The aorta and vena cava were isolated distally, preserving the internal iliac and gonadal vessels. The graft containing the skin, muscles, ligaments, bladder, ureter, rectum, anus and vagina, uterus and ovarian (female), or penile, testis and its ducts (male) was removed <jats:italic>en bloc<\/jats:italic>, flushed, and cold-stored.<\/jats:p><\/jats:sec><jats:sec><jats:title>Recipient operation<\/jats:title><jats:p>The infrarenal aorta and vena cava were isolated and donor\/recipient aorta-aorta and cava-cava end-to-side microanastomoses were performed. After pelvic floor and viscera removal, we performed microanastomoses between the donor and the recipient ureter, and the rectum and pudenda nerves. The pelvic floor was repositioned in its original position (orthotopic model) or the abdominal wall (heterotopic model). We sacrificed the animals 2 h after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We performed seven orthotopic and four heterotopic transplantations. One animal from the orthotopic model and one from the heterotopic model died because of technical failure. Six orthotopic and three heterotopic recipients survived up to 2\u2005h after transplantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The microsurgical technique for pelvic floor transplantation in rats is feasible, achieving an early survival rate of 81.82%.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2023.1086651","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T15:00:39Z","timestamp":1682002839000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Multivisceral transplantation of pelvic organs in rats"],"prefix":"10.3389","volume":"10","author":[{"given":"Flavio Henrique Ferreira","family":"Galvao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Araki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Bruna Salles","family":"Fonseca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Ruy Jorge","family":"Cruz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinthia","family":"Lanchotte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Reis","family":"Waisberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleazar","family":"Chaib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Souto","family":"Nacif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Clara de Camargo","family":"Traldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estrella Bianco de","family":"Mello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wellington","family":"Andraus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz","family":"Carneiro-D'Albuquerque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1111\/j.1532-5415.1998.tb02468.x","article-title":"Prevalence of combined fecal and urinary incontinence: a community based study","volume":"47","author":"Roberts","year":"1999","journal-title":"J Am Geriatr Soc"},{"key":"B2","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1034\/j.1600-0412.2003.00103.x","article-title":"Prevalence of urinary and fecal incontinence and symptoms of genital prolapse in women","volume":"82","author":"Eva","year":"2003","journal-title":"Acta Obstet Gynecol Scand"},{"key":"B3","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1067\/mob.2003.548","article-title":"The functional and psychosocial impact of fecal incontinence in women with urinary incontinence","volume":"189","author":"Fialkow","year":"2003","journal-title":"Am J Obstet Gynecol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1016\/s0029-7844(02)02215-9","article-title":"Prevalence of anal incontinence in women with symptoms of urinary incontinence and genital prolapse","volume":"100","author":"Meschia","year":"2002","journal-title":"Obstet Gynecol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1097\/AOG.0000000000000057","article-title":"Prevalence and trends of symptomatic pelvic floor disorders in U.S. Women","volume":"123","author":"Wu","year":"2014","journal-title":"Obstet Gynecol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1007\/s10350-003-0114-6","article-title":"Long-term results of anterior sphincteroplasty","volume":"47","author":"Gutierrez","year":"2004","journal-title":"Dis Colon Rectum"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1427","DOI":"10.1007\/BF02234593","article-title":"Dynamic graciloplasty therapy study\u00a0group. Complications of dynamic graciloplasty: incidence, management, and\u00a0impact on outcome","volume":"44","author":"Matzel","year":"2001","journal-title":"Dis Colon Rectum"},{"key":"B8","first-page":"A15","article-title":"Artificial anal sphincter: preliminary results of a multicenter prospective trial","volume":"41","author":"Spencer","year":"1998","journal-title":"Dis Colon Rectum"},{"key":"B9","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1002\/bjs.7302","article-title":"Suboptimal outcome following sacral nerve stimulation for faecal incontinence","volume":"98","author":"Maeda","year":"2011","journal-title":"Br J Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"26S","DOI":"10.1097\/PRS.0b013e318191bca2","article-title":"A model for functional recovery and cortical reintegration after hemifacial composite tissue allotransplantation","volume":"123","author":"Washington","year":"2009","journal-title":"Plast Reconstr Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1056\/NEJMoa0810653","article-title":"Tracheal allotransplantation after withdrawal of immunosuppressive therapy","volume":"14","author":"Delaere","year":"2010","journal-title":"N Engl J Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1111\/j.1600-6143.2011.03503.x","article-title":"Bilateral trans-humer arm transplantation: result at 2 years","volume":"11","author":"Cavadas","year":"2011","journal-title":"Am J T Ransplant"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2762","DOI":"10.1111\/j.1600-6143.2011.03782.x","article-title":"The first successful\u00a0lower extremity transplantation: 6-year follow-up and implications for cortical plasticity","volume":"11","author":"Fattah","year":"2011","journal-title":"Am J Transplant"},{"key":"B14","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1097\/00007890-201407151-01352","article-title":"Surgical technique for pelvic floor transplantation","volume":"3","author":"Galvao","year":"2014","journal-title":"Am J Transplant"},{"key":"B15","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1007\/pl00012129","article-title":"Anorectal transplantation","volume":"13","author":"Galv\u00e3o","year":"2009","journal-title":"Tech Coloproctol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"30894","DOI":"10.1038\/srep30894","article-title":"Allogeneic anorectal transplantation in rats: technical considerations and preliminary results","volume":"4","author":"Galv\u00e3o","year":"2016","journal-title":"Sci Rep"},{"key":"B17","doi-asserted-by":"publisher","first-page":"971","DOI":"10.6061)\/clinics\/2012(08)20","article-title":"An innovative model of autologous anorectal transplantation with pudendal nerve reconstruction","volume":"67","author":"Galvao","year":"2012","journal-title":"Clinics (Sao Paulo)"},{"key":"B18","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1002\/micr.20958","article-title":"Intestinal transplantation including anorectal segment in the rat","volume":"32","author":"Galv\u00e3o","year":"2012","journal-title":"Microsurgery"},{"key":"B19","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1002\/bjs.9762","article-title":"Functional outcome of autologous anorectal transplantation in an experimental model","volume":"102","author":"Seid","year":"2015","journal-title":"Br J Surg"},{"key":"B20","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/j.transproceed.2015.10.082","article-title":"Evidence that anorectal transplantation is the logical treatment for serious anorectal dysfunction and permanent colostomy","volume":"48","author":"Galvao","year":"2016","journal-title":"Transplant Proc"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e68977","DOI":"10.1371\/journal.pone.0068977","article-title":"Anorectal transplantation in human cadavers: mock anorectal allotransplantation","volume":"8","author":"Araki","year":"2013","journal-title":"PLoS One"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e44310","DOI":"10.1371\/journal.pone.0044310","article-title":"The development of a canine anorectal autotransplantation model based on blood supply: a preliminary case report","volume":"7","author":"Araki","year":"2012","journal-title":"PLoS One"},{"key":"B23","doi-asserted-by":"publisher","first-page":"3552","DOI":"10.1016\/j.transproceed.2011.08.042","article-title":"Vascularized anal autotransplantation model in rats: preliminary report","volume":"43","author":"Araki","year":"2011","journal-title":"Transplant Proc"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1534","DOI":"10.1046\/j.1365-2168.2000.01557.x","article-title":"Experimental model of anorectal transplantation","volume":"87","author":"O'Bichere","year":"2000","journal-title":"Br J Surg"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e60","DOI":"10.1016\/j.esxm.2016.01.001","article-title":"Long-Term follow-up of individuals undergoing sex-reassignment surgery: somatic morbidity and cause of death","volume":"4","author":"Simonsen","year":"2016","journal-title":"Sex Med"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1837","DOI":"10.1111\/jsm.12936","article-title":"Male-to-female genital reassignment surgery: a retrospective review of surgical technique and complications in 60 patients","volume":"12","author":"Raigosa","year":"2015","journal-title":"J Sex Med"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2023.1086651\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T15:00:42Z","timestamp":1682002842000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2023.1086651\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,20]]},"references-count":26,"alternative-id":["10.3389\/fsurg.2023.1086651"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2023.1086651","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,20]]},"article-number":"1086651"}}