Uterine transplantation from a deceased donor could become an available option for widely treating uterine infertility. However, this procedure requires more precise knowledge about the graft's tolerance to extended cold ischemia. Here, we sought to assess the uterine metabolic alterations after extended cold ischemic storage in a model of auto-transplantation in ewe. A total of 14 uterine auto-transplantations were performed, divided into 2 groups: 7 after 3 h of cold ischemia time (CIT) and 7 after 24 h. Venous uterine blood was collected before uterus retrieval and during reperfusion (30, 60 and 90 min); thereafter, blood gases, lactate, glucose and amino acids (AAs) were analyzed. Apoptosis analyses were performed before uterus retrieval and following reperfusion in uterus biopsies. A total of 12 uterine auto-transplantations were successfully performed and 7 ewes were alive ≥8 days after transplantation. After reperfusion, a decrease in pH, a rise of lactate and lactate/glucose ratio and a delayed decrease of pO2 were found in the 3 h CIT group. No significant variation of these parameters was observed in the 24 h CIT group. Significant decreases of AAs were observed during reperfusion and these decreases were more pronounced and concerned a larger number of compounds in the 24 h CIT group than in the 3 h CIT group. There was no significant uterine apoptotic signal in either group. Overall, these results suggest that extended CIT storage delayed restoration of aerobic glycolysis and induced an increase in AA requirements of the uterus after reperfusion. However, this biochemical alteration did not reduce success rate for uterine transplantation.

中文翻译：

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长期低温缺血存储后子宫移植物的代谢变化：在母羊中进行的实验研究。

从已故的供者那里进行子宫移植可能成为广泛治疗子宫不育症的一种可行选择。但是，此程序需要有关移植物对长期冷缺血的耐受性的更精确的知识。在这里，我们试图在母羊自体移植模型中评估长期冷缺血存储后的子宫代谢改变。总共进行了14例子宫自体移植，分为两组：冷缺血时间（CIT）3小时后7例和24小时后7例。在子宫取回前和再灌注期间（30、60和90分钟）收集静脉子宫血。此后，分析血气，乳酸，葡萄糖和氨基酸（AAs）。在子宫取回之前和子宫活检再灌注后进行凋亡分析。总共成功进行了12例子宫自体移植，并且在移植后≥8天存活了7头母羊。再灌注后，在3 h CIT组中发现pH降低，乳酸和乳酸/葡萄糖比升高以及pO2延迟降低。在24小时CIT组中未观察到这些参数的显着变化。在再灌注过程中观察到AA的显着下降，并且与3 h CIT组相比，在24 h CIT组中这些下降更为明显，并且涉及更多的化合物。两组均未见明显的子宫凋亡信号。总体而言，这些结果表明延长的CIT储存延迟了有氧糖酵解的恢复，并导致了再灌注后子宫对AA的需求增加。然而，