Vascular Support of the Transplanted UterusThe hysterectomy performed for uterine transplantation isnot a simple hysterectomy. For this reason, the average timefor recovery of the uterus in a living donor using an exploratorylaparotomy and a highly skilled surgical teamconsisting of both gynecologic and transplant surgeons inDr. Brännström’s work was 10 to 13 hours.10 Reducing thetime for uterine procurement from the donor and reducingdonor complications is an ongoing goal in a living donormodel, as genitourinary complications were reported in theSwedish and Saudi Arabian attempts with living donors. Inthe series of five transplants performed in Texas, the authorsreported a few transient adverse events in donors as wellas one major complication, a vaginal cuff dehiscence whichrequired surgical repair.15 The major difficulty in recoveringa uterus is the complex dissection of the uterine vessels,especially the uterine vein, which in the series from Swedenwas anastomosed to the external iliac veins for venous drainageof the uterus. The complex anatomy of the uterine veinincludes multiple branches and close proximity to the ureter.These factors increase the surgical risks to the donor, which