Anatomie cévního zásobení lidské dělohy s ohledem na transplantaci dělohy

• Název práce v češtině: Anatomie cévního zásobení lidské dělohy s ohledem na transplantaci dělohy
• Název v anglickém jazyce: Anatomy of the human uterus vascular supply with respect to uterus transplantation
• Klíčová slova: Anatomie, cévní zásobení, děloha, kolaterální řečiště, transplantace dělohy, trombóza štěpu
• Klíčová slova anglicky: Anatomy, blood supply, collateral circulation, graft thrombosis, uterine transplantation, uterus
• Akademický rok vypsání: 2017/2018
• Typ práce: disertační práce
• Jazyk práce: čeština
• Ústav: Ústav anatomie (13-320)
• Vedoucí / školitel: prof. MUDr. Jiří Froněk, Ph.D.
• Řešitel: skrytý - zadáno a potvrzeno stud. odd.
• Datum přihlášení: 31.10.2017
• Datum zadání: 31.10.2017
• Datum potvrzení stud. oddělením: 31.10.2017
• Datum a čas obhajoby: 22.11.2023 10:45
• Datum odevzdání elektronické podoby: 12.09.2023
• Datum odevzdání tištěné podoby: 15.09.2023
• Datum proběhlé obhajoby: 22.11.2023
• Oponenti: MUDr. Radovan Turyna, Ph.D.
• Konzultanti: prof. MUDr. David Kachlík, Ph.D.

Seznam odborné literatury

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Předběžná náplň práce

Tato dizertační práce pojednává o cévním řečišti lidské dělohy a jeho významu pro transplantaci dělohy. První část dizertační práce shrnuje anatomické informace o tepenném a žilním řečišti dělohy včetně jeho kolaterál, cituje některé významné latinské texty, předkládá vývoj metody včetně experimentů na zvířatech, techniku transplantace, výhody a limitace štěpů od žijících a zemřelých dárkyň. Další část dizertační práce se zabývá publikacemi. Cílem první studie bylo ověřit existenci ipsilaterálních a kontralaterálních tepenných anastomóz dělohy. Oba typy byly nástřikem tuší prokázány ve všech preparátech (9/9). Druhá studie analyzovala dva případy trombózy štěpu. Příčinou jedné bylo zúžení tepny subintimální fibrózou s nasedajícím trombem, u druhé nejspíše útlak výtokové žíly hematomem a nejasný podíl humorální rejekce. Trombektomie nevedla k záchraně štěpů. Třetí práce porovnala vhodnost CT a MR angiografie k hodnocení kvality cév dělohy. Role těchto metod je komplementární. Byla navržena radiologická klasifikace kvality děložních cév. Další studie shrnuje výsledky české studie transplantace dělohy. Další dvě publikace jsou případové studie pacientky po transplantaci dělohy od zemřelé nikdy netěhotné dárkyně. První studie popisuje onemocnění akutní apendicitidou této pacientky. Další popisuje poprvé popsané dosažení porodu dítěte štěpem od nuliparozní dárkyně. Další studie porovnala počet zemřelých dárkyň s počtem žen trpících absencí dělohy. Zjistila nadbytek žen trpících absencí dělohy v poměru 107:1. Další studie hodnotila vliv imunosuprese na ledvinové funkce příjemkyň štěpu dělohy. Pozorovala poškození ledvinových funkcí, přičemž hysterektomie a vysazení imunosuprese nevedla k plné obnově ledvinových funkcí.

Předběžná náplň práce v anglickém jazyce

This dissertation thesis deals with the blood supply of the human uterus and its relevance to uterus transplantation. The first section summarizes what is commonly known of the anatomy of the arterial and venous uterine blood supply including collaterals. It also quotes a few classical anatomical texts, illustrates the transplantation technique, and the pros and cons of utilizing uterine grafts from living and deceased donors. The second section deals with nine publications, the first of which aimed to verify the existence of ipsilateral and contralateral arterial anastomoses. Both types were verified in all specimens (9/9). The second publication analysed two cases of graft thrombosis. The first was brought about through narrowing of the uterine artery, while the other was caused by compression from hematoma. Thrombectomy was unsuccessful in both cases. The third publication compared the utility of CT to that of MR angiography for evaluating uterine vessel quality. These two methods are complementary. The study presents a new radiological classification system suggested to assess uterine vessels. Another publication reports the interim results of a Czech uterus transplant study. Another study presents a uterus transplant recipient who suffered from acute appendicitis. Another study reports the first published live birth from a deceased donor nulliparous uterine transplant. Another study determined the ratio of deceased donors to women suffering from uterine agenesis. Their findings disclosed a surplus of women with uterine agenesis at a ratio of 107:1. Another study looked at how immunosuppression affects renal function in uterus recipients and observed signs of impairment. A graft hysterectomy and cessation of immunosuppression did not lead to full restoration of renal function.