Baboons were used in uterine autotransplantation research. The uterus, ovaries, fallopian tubes, cervix and part of the vagina were surgically removed from each animal and then replaced and sutured back into the same animal
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The work was carried out at the Institute of Primate Research (IPR), Nairobi, Kenya, and approved by its
institutional ethical committee
. Most of the researchers were from facilities in California, Texas and Mexico The only financial support reported was self-funding by one of the authors from Community Memorial Hospital, Oxnard, CA, USA. The research was referred to as a
, which means further similar research on baboons is likely.
The purpose of this
was to develop surgical techniques in uterine autotransplantation in baboons. Eight adult female baboons were used, but there was no mention of the species or the source of the animals, although the IPR has previously carried out research on wild baboons captured in Kenya. After anaesthesia, an incision was made into the abdomen to remove the reproductive tract as one block of organs. The organ block was taken to a
where the blood vessels were irrigated with a saline and heparin solution until all blood was removed and the
organ turned white
. This preparation procedure lasted for two to three hours, presumably while the baboon remained under anaesthesia on the surgical table. The reproductive tract was then
placed back into the same animal
and reattached with sutures. This was complex surgery and, in all, the animals were subjected to an average of about six hours of surgery. Afterwards, they were taken to a postoperative recovery area.
Shockingly, three of the baboons died immediately post-surgery, two from
and one from
postoperative gastric aspiration
(taking stomach contents into the lungs after vomiting). The researchers note that surgery time was longer because the donor and recipient were the same animal and this may have contributed to the increased mortality. The only likely way for an animal to die of dehydration
, however, would be if adequate fluids were not provided or if the animal was not drinking. If an animal is not drinking, however, proper procedure would be to supply fluids in alternate ways, such as intravenously, subcutaneously or via gavage ('stomach tube'). For an animal to die of dehydration in a situation like this means there could not have been adequate monitoring.
Gastric aspiration as a cause of death also raises questions about whether proper procedures were followed. There was no mention whether food and fluids were withheld prior to surgery, as must be done in order to reduce the chance of regurgitation. When an animal is under anaesthesia, a properly applied endotracheal tube should prevent aspiration in the unlikely event that an animal vomits (regurgitates) while under anaesthesia even if food and fluids had been properly withheld. This is the reason why the endotracheal must not be removed until the animal is conscious enough to assume normal bodily functions such as swallowing. That way, if the animal vomits, he or she can swallow, reducing the chance of aspiration. Because the authors provide no details on how the baboon died of
, there is no way to know if this happened despite proper monitoring.
Three other animals suffered from leg weakness, which the researchers attributed to hyperextension of the lower extremities (hind legs). The animals were kept in cages where they were monitored for a few days. They were followed up for only one month after surgery, before being
to the primate centre. The researchers claimed that, because of the limited goals of the study (only evaluating surgical technique), there was no need for long-term follow up of the animals. Aside from following up from an animal welfare perspective, an important part of assessing the effectiveness of surgical technique is to determine if it allows for normal function
. As it stands, there is no way of knowing whether the animals had any complications later, or if their reproductive organs would have even been functional.
Also, because this was autotransplantation, the important issue of rejection of tissue from a different donor was not addressed. The authors acknowledged this as a limitation of the work and admitted that donor-to-recipient transplantation would be more characteristic of true human uterine transplants, rather than the donor and recipient being the same person.
Further, donor-to-recipient uterine transplantation is already being done in people
, despite the moral dilemmas associated with this surgery and which the authors of the baboon study acknowledged. For example, the surgery is not needed for preservation of human life and other options are available such as adoption and surrogacy, where the potential morbidity associated with uterine transplantation for the patient, foetus and live donor is absent. These eight sentient beings the baboons were, therefore, subjected to considerable surgical mutilation, pain and suffering and death for three of them to develop a surgical technique in baboons which has no relevance to the baboons or humans.
Kristek, Jakub; Johannesson, Liza; Novotny, Robert; Kachlik, David and Fronek, Jiri. 2020-11-01. "Human uterine vasculature with respect to uterus transplantation: A comprehensive review" The Journal of Obstetrics and Gynaecology Research 46(11):2199-2220.