Warm Ischemia Type 1 in Human Uterine Myometrium –Basic Study Toward Uterine Transplantation

Abstract

Introduction: It is well known that infertility can interfere substantially with psychological health and that most subtypes of uterine infertility still remain untreatable. Thus, patients lacking a uterus due to congenital uterine agenesis or previous hysterectomy (secondary to malignancy, large/inoperable myoma or life-threatening obstetric bleeding), or with untreatable uterine malformations or severe intrauterine adhesions still do not have a real possibility of achieving motherhood. Aims: The aim of this study is to evaluate the tolerance of human uterine myometrial tissue to warm ischemia type I. Methodology: Prospective Pilot study. Ain Shams Maternity University Hospital. From fifteen December 2015 till fifteen December 2016. Fifteen (15) women with premenopausal bleeding were included in the current study and were subjected to surgery of total abdominal hysterectomy and bilateral salpingeoopherectomy. Results: The biopsies taken for the study divided into 5 groups: Group 1: biopsies were taken at zero hour as a control to evaluate histological state by light microscope before vascular clamping, 4 Groups (warm ischemic groups): biopsies were taken every 1 hour with average 4 samples from vascular clamping for each case. Conclusion: this study, the allowable warm ischemic time type 1 in human uterine myometrium under 3 hours and presence of positive correlation between increasing duration of warm ischemia over that time and significant ischemic injury by histopathological assessment. Recommendation: Positive correlation between prolongation of warm ischemia and ischemic injury in human uterine myometrium and the allowable warm ischemic time type 1 in human uterine myometrium under 3 hours. Keywords: Warm Ischemia Type 1, Human Uterine Myometrium, Basic Study Toward Uterine Transplantation