Heterotopic uterus transplantation in a swine model.
BACKGROUND
The aim of our study was to examine the feasibility of allogeneic uterine transplantation in a large animal model.


METHODS
We performed heterotopic uterine transplants in genetically defined mini-pigs. Immunosuppression was tacrolimus administered intravenously for the first 12 days posttransplantation followed by oral cyclosporine maintenance immunosuppression. The graft was transplanted heterotopically in the lower abdominal cavity of the recipient. The vaginal vault was exteriorized as a stoma in the lower right abdominal wall. The uterine grafts were followed with endoscopies and biopsies.


RESULTS
Ten transplants were performed. Follow-up was until July 2008. At the end of the follow-up period, 5 animals were alive and healthy, 0.5 to 12 months posttransplantation. There were 5 deaths due to pneumonia (n=1), intussusception of the graft (n=1), cardiorespiratory arrest during anesthesia (n=1), and complications of the stoma (n=2). Acute rejections of the graft presented during the 2nd and 3rd month posttransplantation were treated successfully with increase of the maintenance immunosuppression and steroids. Other complications included prolapse and infections of the graft stoma. Pathological changes seen in the endometrial biopsies included acute rejection and acute endometritis.


CONCLUSIONS
These findings demonstrate that successful uterus transplantation in a large animal model (miniature swine) is feasible using this heterotopic model, and it can be useful for the study of these transplants.
Avison
Donna L
DL
Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
DeFaria
Werviston
W
Tryphonopoulos
Panagiotis
P
Tekin
Akin
A
Attia
George R
GR
Takahashi
Hidenori
H
Jin
Yide
Y
Palaios
Emmanouil
E
Pararas
Nikolaos
N
Carreno
Manuel R
MR
Santiago
Sergio
S
Bazer
Fuller
F
Ruiz
Phillip
P
Tzakis
Andreas
A
D000818:Animals; D004716:Endometritis / Q000209:etiology / Q000473:pathology; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000473:pathology; D006085:Graft Survival; D023421:Models, Animal; D013552:Swine; D013556:Swine, Miniature; D016042:Transplantation, Heterotopic / Q000009:adverse effects / Q000276:immunology / Q000379:methods; D014184:Transplantation, Homologous; D014599:Uterus / Q000276:immunology / Q000473:pathology / Q000637:transplantation*