Modified uterine allotransplantation and immunosuppression procedure in the sheep model

To develop an orthotopic, allogeneic, uterine transplantation technique and an effective immunosuppressive protocol in the sheep model. In this pilot study, 10 sexually mature ewes were subjected to laparotomy and total abdominal hysterectomy with oophorectomy to procure uterus allografts. The cold...

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Bibliographic Details
Published in:PloS one 2013-11, Vol.8 (11), p.e81300-e81300
Main Authors: Wei, Li, Xue, Tao, Yang, Hong, Zhao, Guang-Yue, Zhang, Geng, Lu, Zhi-Hong, Huang, Yan-Hong, Ma, Xiang-Dong, Liu, Hai-Xia, Liang, Sheng-Ru, Yang, Fang, Chen, Bi-Liang
Format: Article
Language:English
Subjects:
Allografts
Analysis
Anastomosis
Anatomy
Animals
Edema
Female
Fertility
Glucocorticoids
Graft Survival
Gynecology
Human anatomy
Hysterectomy
Immunosuppression
Immunosuppression - methods
Immunosuppressive agents
Immunotherapy
Infertility
Inflammation
Ischemia
Li Wei
Medical research
Methylprednisolone
Mycophenolate mofetil
Mycophenolic acid
Obstetrics
Organ Transplantation - methods
Otolaryngology
Ovariectomy
Postoperative Care
Pregnancy
Reperfusion
Rodents
Sheep
Studies
Surgery
Surrogate mothers
Sutures
Tablets
Tacrolimus
Thromboembolism
Thrombosis
Transplantation
Transplantation, Homologous
Transplants & implants
Ultrasound
Ultrasound imaging
Uterus
Uterus - transplantation
Viability
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Summary:To develop an orthotopic, allogeneic, uterine transplantation technique and an effective immunosuppressive protocol in the sheep model. In this pilot study, 10 sexually mature ewes were subjected to laparotomy and total abdominal hysterectomy with oophorectomy to procure uterus allografts. The cold ischemic time was 60 min. End-to-end vascular anastomosis was performed using continuous, non-interlocking sutures. Complete tissue reperfusion was achieved in all animals within 30 s after the vascular re-anastomosis, without any evidence of arterial or venous thrombosis. The immunosuppressive protocol consisted of tacrolimus, mycophenolate mofetil and methylprednisolone tablets. Graft viability was assessed by transrectal ultrasonography and second-look laparotomy at 2 and 4 weeks, respectively. Viable uterine tissue and vascular patency were observed on transrectal ultrasonography and second-look laparotomy. Histological analysis of the graft tissue (performed in one ewe) revealed normal tissue architecture with a very subtle inflammatory reaction but no edema or stasis. We have developed a modified procedure that allowed us to successfully perform orthotopic, allogeneic, uterine transplantation in sheep, whose uterine and vascular anatomy (apart from the bicornuate uterus) is similar to the human anatomy, making the ovine model excellent for human uterine transplant research.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0081300