Uterus tolerance to extended cold ischemic storage after auto-transplantation in ewes

Abstract Objective To assess how the uterus tolerates extended cold ischemic storage before auto-transplantation in ewes. Study design Fourteen uterine auto-transplantations were performed in ewes from November 2014 to June 2015 at the Analysis and Research Laboratory of Limoges, France. The animals were divided into 2 groups: 7 after 3 h of cold ischemia timeand 7 after 24 h. Transplant was assessed ≥8 days after transplantation. Histology and apoptosis analyses (TUNEL method and indirect immunohistochemistry of cleaved Caspase 3) were performed before uterus retrieval (control), after 90 min following reperfusion and ≥8 days after transplantation. Results Twelve uterine auto-transplantations were successfully performed. The histological analysis at 90 min following reperfusion revealed a moderate inflammation of the endometrium and serosa in the 3-h group and severe inflammation in the 24-h group, but no significant apoptotic signal was found in either group. Seven ewes were alive at ≥8 days after transplantation: the macroscopic and histological analyses revealed two viable uteri in the 3-h group and three in the 24-h group. In each group one uterus was necrotic. Conclusion These first results in ewes suggest that the uterus is an organ with a good tolerance to extended cold ischemic storage before transplantation.