Autotransplantation of uterus on animal model preliminary to clinical application. Abstracts of the 20th Biennial European Society for Organ Transplantation (ESOT) Congress

Background: Uterus transplantation is a “purpose” transplant, functional to achieve pregnancy in patients with absolute uterine infertility and not a life-saving transplant. Its introduction into the clinic practice requires careful planning that cannot be separated from an experimental phase on an animal model. Methods: The initial phase of the uterus transplant protocol in the mini-pig that we have developed involves an autotransplant model, to become familiar with the more complex procedure of uterine transplantation. After isolating the internal and external ureters and iliac arteries, we isolated the uterine artery and uterine veins. The vagina and uterine vessels were dissected and the uterus retrieved. During the back table surgery, the uterus was perfused with Celsior's solution and intrauterine circles were evaluated. Trucut uterus biopsies were performed before clamping, at the end of perfusion with Celsior, after 1 hour of cold static storage, and after reperfusion. The uterine vessels and vagina were re-implanted on the resection abutments. Results: At the reperfusion vessels were patent and the reperfusion was homogeneous. The overall operating time was 11 hours. The first warm ischemia time was 2-minutes. The second warm ischemia was 45 minutes. At the biopsies no relevant histological changes between the various phases. Conclusions: Surgery on an animal model is preparatory for clinical activity on a human being.