title: Heterotopic uterus transplantation in a swine model.
abstract: 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.
authors.affiliation: Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Donna L
authors.initials: DL
authors.lastname: Avison
authors.forename: Werviston
authors.initials: W
authors.lastname: DeFaria
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tryphonopoulos
authors.forename: Akin
authors.initials: A
authors.lastname: Tekin
authors.forename: George R
authors.initials: GR
authors.lastname: Attia
authors.forename: Hidenori
authors.initials: H
authors.lastname: Takahashi
authors.forename: Yide
authors.initials: Y
authors.lastname: Jin
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Palaios
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Pararas
authors.forename: Manuel R
authors.initials: MR
authors.lastname: Carreno
authors.forename: Sergio
authors.initials: S
authors.lastname: Santiago
authors.forename: Fuller
authors.initials: F
authors.lastname: Bazer
authors.forename: Phillip
authors.initials: P
authors.lastname: Ruiz
authors.forename: Andreas
authors.initials: A
authors.lastname: Tzakis
mesh_terms: 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*