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22 November 2018 : Animal Research  

Uterus Allo-Transplantation in a Swine Model: Long-Term Graft Survival and Reproductive Function

Xiaoli Zhang1BCE, Jiajia Liu2BF, Qiuxiang Wu3BC, Zhongyu Liu4ABE, Zhifeng Yan4ADG*

DOI: 10.12659/MSM.913051

Med Sci Monit 2018; 24: ANS8422-8429

Abstract

BACKGROUND: The present study examined the feasibility and safety of allogeneic uterus transplantation (UTx) from a living donor and assessed long-term graft survival and the resumption of reproductive function in a swine model.

MATERIAL AND METHODS: Ten female miniature swine with regular menstrual cycles were used; the animals were either donors or recipients (n=5) depending on the sibling. Retrieval surgery included uterus and uterine arteries together with the anterior branches of the internal iliacs from the living donor; the vaginal canal was cut. After the back-table had been prepared, bilateral internal iliac arteries were anastomosed end-to-side with the external iliac arteries. The transplanted uterus was evaluated based on the arterial blood flow by transabdominal ultrasonography and observed by secondary laparotomy after surgery; estrus recovery was stimulated by mating with a male, and artificial embryo transfer was performed in healing swine.

RESULTS: All 5 pigs revealed successful surgery without any surgical complications, injuries to other organs, or unanticipated vascular injury. All recipients survived for >3 months after the surgery, except pig 5, which died due to uterus necrosis 3 days post-surgery. A 100% surgical success rate and 80% long-term survival rate of the receptor were observed. Pig 2 had temporary estrus resumed, and the artificial embryo was transplanted 3 months after surgery; however, apparent gestation was not found by ultrasonography.

CONCLUSIONS: This study evaluated the safety and feasibility of the technology of allogeneic UTx, which was performed only by transplant uterine artery system from living-donor surgery in a swine model. Laboratory animals can show long-term survival and resumed estrous after UTx, which can be monitored by ultrasonography to assess the arterial blood flow of the grafted uterus.

Keywords: Sterilization, Reproductive, Swine, Translations, Uterus

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750