School of Medicine, Guangxi University, Nanning, Guangxi, P. R. China.
Xiamen Key Laboratory of Regeneration Medicine, Fujian Provincial Key Laboratory of Organ and Tissue Regeneration, Organ Transplantation Institute, School of Medicine, Xiamen University, Xiamen, Fujian, P. R. China.
Transplantation. 2024 Sep 1;108(9):e207-e217. doi: 10.1097/TP.0000000000004979. Epub 2024 Mar 19.
Uterus transplantation (UTx) is an emerging treatment for uterine factor infertility. Determining the maximum tolerable cold ischemia time is crucial for successful UTx. However, the limit for cold ischemia in the uterus is unclear. This study aimed to examine cold ischemia's effects on mouse uteri and identify the maximum cold ischemia duration that uteri can endure.
We systematically assessed the tolerance of mouse uteri to extended cold ischemia, 24 h, 36 h, and 48 h, using the cervical heterotopic UTx model. Multiple indicators were used to evaluate ischemia-reperfusion injury, including reperfusion duration, macroscopic examination, oxidative stress, inflammation, and histopathology. The function of transplants was evaluated through estrous cycle monitoring and embryo transfer.
Mouse uteri subjected to 48 h of cold ischemia exhibited significant delays and insufficiencies in reperfusion, substantial tissue necrosis, and loss of the estrous cycle. Conversely, uteri that underwent cold ischemia within 36 h showed long survival, regular estrous cycles, and fertility.
Our study demonstrated that mouse uteri can endure at least 36 h of cold ischemia, extending the known limits for cold ischemia and providing a pivotal reference for research on the prevention and treatment of cold ischemic injury in UTx.
子宫移植（UTx）是治疗子宫因素不孕的一种新兴疗法。确定最大耐受冷缺血时间对于成功的 UTx 至关重要。然而，子宫的冷缺血极限尚不清楚。本研究旨在研究冷缺血对小鼠子宫的影响，并确定子宫能够耐受的最长冷缺血时间。
我们使用颈异位 UTx 模型系统地评估了小鼠子宫对延长冷缺血（24 小时、36 小时和 48 小时）的耐受能力。使用多种指标评估缺血再灌注损伤，包括再灌注持续时间、肉眼检查、氧化应激、炎症和组织病理学。通过发情周期监测和胚胎移植评估移植物的功能。
接受 48 小时冷缺血的小鼠子宫表现出明显的再灌注延迟和不足、大量组织坏死和发情周期丧失。相比之下，接受 36 小时冷缺血的子宫表现出较长的存活时间、规律的发情周期和生育能力。
我们的研究表明，小鼠子宫至少可以耐受 36 小时的冷缺血，延长了已知的冷缺血极限，为 UTx 中冷缺血损伤的预防和治疗研究提供了重要参考。
