Extracorporeal perfusion of the human uterus as an experimental model in gynaecology and reproductive medicine

Experimental perfusion of various organs has primarily been used in transpl antation medicine to study the physiology, pathophysiology and metabolism o f tissues and cells. The purpose of this study was to establish an experime ntal model for the extracorporeal perfusion of the human uterus with recirc ulation of a modified, oxygenated Krebs-Henselait solution, in comparison w ith a non-recirculating perfusion system. With consent of the patients we o btained 25 uteri after standard hysterectomy, We performed an isovolumetric exchange of the perfusion medium at different intervals from 1 to 6 h and examined pH, pO(2), pCO(2), lactate, lactate dehydrogenase and creatine kin ase by taking arterial and venous samples every hour for 24 h, We found the perfusions to be adequate when maintaining how rates at 15-35 ml/min and a t pressures ranging from 70 to 130 mmHg. Isovolumetric exchange of the perf usate every 3-4 h was the maximum interval to keep pH, the arterio-venous g radients of pO(2) and pCO(2), and the other biochemical parameters in physi ological ranges, Examination by light and electron microscopy showed well-p reserved features of myometrial and endometrial tissue. However, a 6 h exch anging interval led to increasing hypoxic and cytolytic parameters during t he whole perfusion period. X-ray studies using digital subtraction angiogra phy and perfusion studies with methylene blue demonstrated the homogeneous distribution of the perfusion fluid throughout the entire organ.