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Publications

Journal Article Video-Audio Media Epublish 3 citations

PubMed: 39760401 DOI: 10.3791/67357

Establishing a Swine Model to Study Uterus Dynamic Preservation and Transplantation.

J Vis Exp

Authors: Lucile Cabanel, Haïzam Oubari, Ludivine Dion, Vincent Lavoué, Mark A Randolph, Curtis L Cetrulo, Korkut Uygun, Alexandre G Lellouch, Yanis Berkane, Basak E Uygun

Affiliations

  • Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston; Plastic Surgery Research Laboratory, Department of plastic and reconstructive surgery, Massachusetts General Hospital, Harvard Medical School.
  • Department of Gynecology and Obstetrics, CHU de Rennes, University of Rennes.
  • Shriners Children's Boston; Plastic Surgery Research Laboratory, Department of plastic and reconstructive surgery, Massachusetts General Hospital, Harvard Medical School.
  • Shriners Children's Boston; Plastic Surgery Research Laboratory, Department of plastic and reconstructive surgery, Massachusetts General Hospital, Harvard Medical School; Division of Plastic Surgery Research, Vascularized Composite Allotransplantation Program Development, Cedars-Sinai Hospital.
  • Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston.
  • Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston; Plastic Surgery Research Laboratory, Department of plastic and reconstructive surgery, Massachusetts General Hospital, Harvard Medical School; Division of Plastic Surgery Research, Vascularized Composite Allotransplantation Program Development, Cedars-Sinai Hospital.
  • Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston; Department of Plastic, Reconstructive and Aesthetic Surgery, CHU de Rennes, University of Rennes; SITI Laboratory, UMR1236 INSERM, Établissement Français du Sang, University of Rennes.
  • Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston;.

Abstract

To date, uterus transplantation is the only option for women with absolute uterine infertility, such as those with Rokitansky syndrome, to experience pregnancy and give birth. Despite the growing interest in uterus transplantation in recent years, several issues still require further research, including ischemia-reperfusion injury and its impact on graft quality and rejection. Recent literature has highlighted a thrombotic complication rate of up to 20% following uterus transplantation. This type of complication may result from hypoxia-induced endothelial cell damage, often leading to uterine graft rejection. Hypoxia is induced during static cold storage, which remains the gold standard for graft preservation in solid organ transplantation. Recently, dynamic preservation using machine perfusion has been shown to improve the long-term storage of conventional and marginal organs by reducing ischemic and hypoxic injury. In this protocol, we aim to describe every surgical step involved in porcine uterus procurement and dynamic preservation, based on both uterine pedicles, to enable the connection and initiation of the machine perfusion protocol.

MeSH

Biological Science Disciplines, Uterus, Reperfusion Injury, Transplants, Transplantation