Experimental uterus transplantation.
BACKGROUND
Uterus transplantation (UTx) is developed in animal models as a future method to treat uterine factor infertility.


METHODS
All published studies in the area of UTx research were identified. Aspects relating to surgery, cold-ischemia/reperfusion, rejection, immunosuppression, pregnancy, ethics and institutional requirements were examined.


RESULTS
Uterus retrieval surgery has been solved in animals, including primates. Studies on cold-ischemia/reperfusion indicate an ischemic tolerance of >24 h. The transplantation procedure, with vascular anastomosis, has not been fully developed in animal models, indicated by frequent thrombosis formation. Pregnancies have only been reported in syngenic/auto-UTx animal models. Several ethical issues in relation to UTx, and requirements for a team that would be suitable to undertake human UTx, exist.


CONCLUSIONS
Much research on UTx has been performed in appropriate animal models. Several aspects of the procedure have been optimized but some remain to be solved. It is predicted that the research will soon reach a stage that could merit introduction of human UTx as an experimental procedure.
Brännström
Mats
M
Department of Obstetrics & Gynecology, Sahlgrenska University Hospital, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden. mats.brannstrom@obgyn.gu.se
Wranning
Caiza A
CA
Altchek
Albert
A
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D026688:Bioethical Issues; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000639:trends; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects / Q000379:methods; D007247:Infertility, Female / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D015427:Reperfusion Injury / Q000517:prevention & control; D035703:Therapies, Investigational / Q000009:adverse effects / Q000639:trends; D014599:Uterus / Q000002:abnormalities / Q000502:physiology / Q000637:transplantation*