Hypothermic machine perfusion in uterus transplantation in a porcine model: A proof of concept and the first results in graft preservation

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Main Authors: Carla Héléna Sousa, Marion Mercier, Nathalie Rioux‐Leclercq, Erwan Flecher, Claude Bendavid, David Val‐Laillet, Juliette Ferrant, Sylvie Jaillard, Emma Loiseau, Julien Branchereau, Yanis Berkane, Krystel Nyangoh Timoh, Isis Carton, Maëla Le Lous, Vincent Lavoue, Ludivine Dion
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Published: Wiley 2025
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author Carla Héléna Sousa
Marion Mercier
Nathalie Rioux‐Leclercq
Erwan Flecher
Claude Bendavid
David Val‐Laillet
Juliette Ferrant
Sylvie Jaillard
Emma Loiseau
Julien Branchereau
Yanis Berkane
Krystel Nyangoh Timoh
Isis Carton
Maëla Le Lous
Vincent Lavoue
Ludivine Dion
author_facet Carla Héléna Sousa
Marion Mercier
Nathalie Rioux‐Leclercq
Erwan Flecher
Claude Bendavid
David Val‐Laillet
Juliette Ferrant
Sylvie Jaillard
Emma Loiseau
Julien Branchereau
Yanis Berkane
Krystel Nyangoh Timoh
Isis Carton
Maëla Le Lous
Vincent Lavoue
Ludivine Dion
Carla Héléna Sousa
Marion Mercier
Nathalie Rioux‐Leclercq
Erwan Flecher
Claude Bendavid
David Val‐Laillet
Juliette Ferrant
Sylvie Jaillard
Emma Loiseau
Julien Branchereau
Yanis Berkane
Krystel Nyangoh Timoh
Isis Carton
Maëla Le Lous
Vincent Lavoue
Ludivine Dion
collection Wiley Open Access
contents Hypothermic machine perfusion in uterus transplantation in a porcine model: A proof of concept and the first results in graft preservation Carla Héléna Sousa Marion Mercier Nathalie Rioux‐Leclercq Erwan Flecher Claude Bendavid David Val‐Laillet Juliette Ferrant Sylvie Jaillard Emma Loiseau Julien Branchereau Yanis Berkane Krystel Nyangoh Timoh Isis Carton Maëla Le Lous Vincent Lavoue Ludivine Dion Acta Obstetricia et Gynecologica Scandinavica AbstractIntroductionGraft optimization is a necessity in order to develop uterus transplantation from brain‐dead donors, as a complement to living donors, as these grafts are rare and the last organs retrieved in multiple organ donation. The aim of this study was to assess the feasibility and interest of hypothermic machine perfusion (HMP) in uterus transplantation using a porcine model; secondary outcomes were the evaluation of the graft's tolerance to a prolonged cold ischaemia time and to find new biomarkers of uterus viability.Material and MethodsFifteen uterus allotransplantations were performed in a porcine model, after 18 h of cold ischaemia, divided in three groups: Static cold storage in a HTK solution, HMP (with the VitaSmart (™) machine Bridge to Life Ltd.) with a UW‐MP solution, and static cold storage in a UW solution. The main outcome was macroscopic: uterine arteries pulsatility, recoloration, and bleeding at the cut. Secondary outcomes were histological analyses (Zitkute and inflammation scores), caspase3 immunohistochemistry and plasmatic dosage of biomarkers.Results14/15 allotransplantations were performed according to the protocol and met the criteria of macroscopic vitality. Grafts treated with HMP (MP did not show significantly more tissue) damage than the recipient's uterus, contrary to grafts in static cold storage, independently of the solution used. This difference disappeared one and 3 h after uterus transplantation. Plasma dosages before and after uterus transplantation did not allow to identify a new biomarker of uterus viability.ConclusionsHMP is feasible in a porcine model, without inflicting damage on the grafts during cold ischaemia time. Grafts exposed to HMP seemed to better endure reperfusion phenomena, but this advantage did not last over time. 10.1111/aogs.15056 http://creativecommons.org/licenses/by-nc/4.0/
doi_str_mv 10.1111/aogs.15056
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publisher Wiley
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spellingShingle Hypothermic machine perfusion in uterus transplantation in a porcine model: A proof of concept and the first results in graft preservation
Carla Héléna Sousa
Marion Mercier
Nathalie Rioux‐Leclercq
Erwan Flecher
Claude Bendavid
David Val‐Laillet
Juliette Ferrant
Sylvie Jaillard
Emma Loiseau
Julien Branchereau
Yanis Berkane
Krystel Nyangoh Timoh
Isis Carton
Maëla Le Lous
Vincent Lavoue
Ludivine Dion
Acta Obstetricia et Gynecologica Scandinavica
Hypothermic machine perfusion in uterus transplantation in a porcine model: A proof of concept and the first results in graft preservation Carla Héléna Sousa Marion Mercier Nathalie Rioux‐Leclercq Erwan Flecher Claude Bendavid David Val‐Laillet Juliette Ferrant Sylvie Jaillard Emma Loiseau Julien Branchereau Yanis Berkane Krystel Nyangoh Timoh Isis Carton Maëla Le Lous Vincent Lavoue Ludivine Dion Acta Obstetricia et Gynecologica Scandinavica AbstractIntroductionGraft optimization is a necessity in order to develop uterus transplantation from brain‐dead donors, as a complement to living donors, as these grafts are rare and the last organs retrieved in multiple organ donation. The aim of this study was to assess the feasibility and interest of hypothermic machine perfusion (HMP) in uterus transplantation using a porcine model; secondary outcomes were the evaluation of the graft's tolerance to a prolonged cold ischaemia time and to find new biomarkers of uterus viability.Material and MethodsFifteen uterus allotransplantations were performed in a porcine model, after 18 h of cold ischaemia, divided in three groups: Static cold storage in a HTK solution, HMP (with the VitaSmart (™) machine Bridge to Life Ltd.) with a UW‐MP solution, and static cold storage in a UW solution. The main outcome was macroscopic: uterine arteries pulsatility, recoloration, and bleeding at the cut. Secondary outcomes were histological analyses (Zitkute and inflammation scores), caspase3 immunohistochemistry and plasmatic dosage of biomarkers.Results14/15 allotransplantations were performed according to the protocol and met the criteria of macroscopic vitality. Grafts treated with HMP (MP did not show significantly more tissue) damage than the recipient's uterus, contrary to grafts in static cold storage, independently of the solution used. This difference disappeared one and 3 h after uterus transplantation. Plasma dosages before and after uterus transplantation did not allow to identify a new biomarker of uterus viability.ConclusionsHMP is feasible in a porcine model, without inflicting damage on the grafts during cold ischaemia time. Grafts exposed to HMP seemed to better endure reperfusion phenomena, but this advantage did not last over time. 10.1111/aogs.15056 http://creativecommons.org/licenses/by-nc/4.0/
title Hypothermic machine perfusion in uterus transplantation in a porcine model: A proof of concept and the first results in graft preservation
topic Acta Obstetricia et Gynecologica Scandinavica
url https://obgyn.onlinelibrary.wiley.com/doi/10.1111/aogs.15056