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Uterine Transplant Optimization From a Preclinical Donor Model With Controlled Cardiocirculatory Arrest.
Emma Loiseau1,2, Benoit Mesnard1,2, Sarah Bruneau1
1CRT2I UMR 1064, Nantes Université, CHU Nantes, INSERM, Centre for Research in Transplantation and Translational Immunology, Nantes, France.
Transplantation Direct
|December 13, 2024
Summary
Hypothermic machine perfusion improves uterine graft preservation and reperfusion capacity in deceased donor uterus transplantation. This method enhances tissue oxygenation compared to static cold storage, offering a promising approach for transplantation success.
Area of Science:
- Transplantation Medicine
- Organ Preservation
- Surgical Innovation
Background:
- Uterus transplantation addresses organ shortage for infertility treatment.
- Optimal graft preservation is critical for successful uterine transplantation.
- Deceased donor uterus transplantation requires advanced preservation techniques.
Purpose of the Study:
- To assess the efficacy of oxygenated hypothermic perfusion in uterine transplantation.
- To evaluate hypothermic machine perfusion versus static cold storage for uterus grafts.
- To investigate early ischemia/reperfusion injury markers in preserved uterus grafts.
Main Methods:
- Preclinical porcine model with controlled donation after circulatory death.
- Graft preservation using hypothermic machine perfusion (HMP) or static cold storage (SCS) for 12 hours.
- Ex vivo normothermic machine perfusion (NMP) with oxygenated autologous blood for reperfusion assessment.
- Analysis included resistance index, oxygenation, immunochemistry, and gene expression.
Main Results:
- HMP significantly improved reperfusion capacity, evidenced by decreased resistance indexes (P < 0.0001).
- HMP demonstrated enhanced tissue oxygenation compared to SCS.
- The study confirmed the feasibility of HMP for uterus graft preservation.
Conclusions:
- Hypothermic machine perfusion is a viable method for preserving uterus grafts.
- HMP offers advantages over SCS in improving graft viability and function.
- Findings support further research into HMP for clinical uterine transplantation.
