Uterus transplantation in the rat: Model development, surgical learning and morphological evaluation of healing

Authors


: Caiza A. Wranning, Department of Obstetrics and Gynecology, Sahlgrenska Academy at the University of Gothenburg, SE-413 45, Göteborg, Sweden. E-mail: caiza.wranning@obgyn.gu.se

Abstract

Objective. Experimental uterus transplantation is a growing research field with the aim to develop a treatment for women with absolute uterus factor infertility. The potential risks of surgery and immunosuppressive treatment involved in uterus transplantation need to be identified and minimized in appropriate animal models before clinical trials commence. The aim of the present study was to develop and evaluate a model for uterus transplantation in the rat that can be reproduced and used in future studies concerning critical aspects of uterine function after transplantation. Design. Animal study. Setting. University Hospital. Sample. Uterine tissue sampled at different post-operative time points after non-rejecting uterus transplantation in rats. Methods. Adult, virgin female rats of inbred Lewis strain served as donors and recipients of uterine transplants. Two individuals with no previous microsurgical training performed the transplantations and learning curves were recorded. When transplant survival exceeded 70% for both surgeons, 15 animals were transplanted and grafted uteri were evaluated at 1, 7 and 21 days after surgery by assessment of morphology and enumeration of infiltrating neutrophilic granulocytes. Main outcome measures. Animal survival, graft survival, surgery times, uterine morphology, enumeration of infiltrating neutrophilic granulocytes. Results. Both surgeons gained the necessary microsurgical skills needed to achieve above 70% transplant survival at a similar rate. The signs of post-operative inflammation on day one after transplantation were minor and further reduced at later time points. Conclusion. A reproducible model for uterus transplantation in the rat was developed, which can be used in future studies concerning uterine function after allogenic transplantation.

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