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The effect of warm ischemia at uterus transplantation in a rat model

Authors

  • CÉSAR DÍAZ-GARCÍA,

    1. Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
    2. Department of Obstetrics and Gynecology, La Fe University Hospital, University of Valencia, Valencia, Spain
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  • SHAMIMA N. AKHI,

    1. Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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  • ALICIA MARTÍNEZ-VAREA,

    1. Department of Obstetrics and Gynecology, La Fe University Hospital, University of Valencia, Valencia, Spain
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  • MATS BRÄNNSTRÖM

    1. Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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  • Conflict of interest
    The authors have stated explicitly that there are no conflicts of interest in connection with this article.

  • Preliminary results of this study were presented at the 27th ESHRE Annual Meeting.

  • Please cite this article as: Díaz-García C, Akhi SN, Martínez-Varea A, Brännström M. The effect of warm ischemia at uterus transplantation in a rat model. Acta Obstet Gynecol Scand 2012; 91: DOI:10.1111/aogs.12027.

César Díaz-García, Department of Obstetrics and Gynecology, Hospital Universitario y Politécnico La Fe, Torre F Planta 3a, Bulevar sur s/n, 46026 Valencia, Spain., E-mail: diaz_cesgar@gva.es

Abstract

Objective. Uterus transplantation (UTx) has been proposed as a method to treat women with absolute uterine factor infertility. The aim of this study was to evaluate the viability of the transplanted rat uterus after exposure to long warm ischemic times, in order to mimic a time frame likely to occur in a human situation during complicated pelvic vascular anastomosis surgery. Design. Experimental study. Setting. Obstetrics and Gynecology Department. Population. Female Lewis rats. Methods. Pseudopregnant rats were randomly allocated into two intervention groups, a standardized syngeneic UTx procedure (control; n = 10) and a modified UTx protocol with a four hour extended period of warm ischemia (n = 10). Main outcome measures. Scoring systems of gross morphology and histology at three and six days after transplantation. Results. Evident signs of necrosis were seen in five of 10 animals in the warm ischemia group compared with only one of 10 in the control group. Overall, uterine grafts from the warm ischemia group obtained poorer gross morphology scores. Histological findings correlated with the surgical findings at inspections three and six days after surgery. Conclusions. An extended warm ischemic time has detrimental effects on the survival of the uterus after transplantation.

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