PARENT SESSION
FEMALE REPRODUCTIVE TRACT - B

Wednesday, August 4, 2004
10:30 AM–12:30 PM
Buchanan Courtyard

(804) BASIC STUDIES TOWARDS UTERINE TRANSPLANTATION - COLD PRESERVATION OF HUMAN UTERINE TISSUE.

Almén Wranning, Caiza¹, Kurlberg, Göran², Mölne, Johan³, Brännström, Mats¹, ¹ Dept. of Obstetrics and Gynecology, Göteborg, Sweden² Dept. of Surgery, Göteborg, Sweden³ Dept. of Pathology, Göteborg, Sweden

ABSTRACT- Women with absolute uterine infertility could become gestational mothers if there were a safe method for uterine transplantation. Before any clinical attempts are made though, several issues need to be addressed. One important aspect of any transplantation is the preservation of the organ ex vivo. This is usually done by topical cooling with a preservation solution (PS). The tolerance to cold ischemia (CI) varies between organs and species. We have previously shown that murine uteri, transplanted after 24 h preservation in University of Wisconsin solution (UW), can implant embryos and produce healthy pups. The aim of this study was to i) evaluate the time-dependence of CI-induced changes of human uterine tissue and ii) compare the effect of different PS on human uterine tissue. Material and methods: Tissue specimens from uteri (n = 7, hysterectomy for benign diagnosis) were kept at 4°C for 6 or 24 hours in either Ringer Acetate (RIN), UW or Perfadex (PER) solutions and assessed for changes in different parameters; ability of myometrial muscle strips to contract spontaneously and in response to PGF2a, morphology of myometrium and endometrium by light-microscopy and concentrations of total and oxidized glutathion (GSHtot and GSSG) as well as ATP in myometrium. Results: UW and PER preserved contractile ability for at least 6 h. No severe morphological changes were seen after preservation in any solution for up to 24 h. UW preserved specimens contained higher GSHtot as well as a significantly larger proportion of GSSG compared to control. Both UW and PER preserved ATP better then RIN. Conclusion: Both UW and PER provide satisfactory preservation of morphology, ATP and contractile ability of myometrium. The impact of the larger proportion of GSSG in UW preserved specimens needs further evaluation, but taken together these results indicate that the human uterus is tolerable to CI for at least 6 hours in UW or PER and is in this respect suitable for transplantation.

KEY WORDS: human, uterus transplantation, cold ischemic preservation