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Towards the development of a bioengineered uterus: Comparison of different protocols for rat uterus decellularization.

Journal article
Authors Mats Hellström
Randa Racho El-Akouri
Carina Sihlbom
B M Olsson
Johan Lengqvist
H Bäckdahl
Bengt R Johansson
Michael Olausson
Suchitra Sumitran-Holgersson
Mats Brännström
Published in Acta biomaterialia
Volume 10
Issue 12
Pages 5034–5042
ISSN 1878-7568
Publication year 2014
Published at Institute of Clinical Sciences, Department of Surgery
Institute of Biomedicine
Core Facilities, Proteomics
Institute of Clinical Sciences, Department of Obstetrics and Gynecology
Pages 5034–5042
Language en
Subject categories Obstetrics, Gynecology and Reproductive Medicine


Uterus transplantation (UTx) may be the only possible curative treatment for absolute uterine factor infertility, which affects 1 in every 500 females of fertile age. We recently presented the 6-month results from the first clinical UTx trial, describing nine live-donor procedures. This routine involves complicated surgery and requires potentially harmful immune suppression to prevent rejection. However, tissue engineering applications using biomaterials and stem cells may replace the need for a live donor, and could prevent the required immunosuppressive treatment. To investigate the basic aspects of this, we developed a novel whole-uterus scaffold design for uterus tissue engineering experiments in the rat. Decellularization was achieved by perfusion of detergents and ionic solutions. The remaining matrix and its biochemical and mechanical properties were quantitatively compared from using three different protocols. The constructs were further compared with native uterus tissue composition. Perfusion with Triton X-100/dimethyl sulfoxide/H2O led to a compact, weaker scaffold that showed evidence of a compromised matrix organization. Sodium deoxycholate/dH2O perfusion gave rise to a porous scaffold that structurally and mechanically resembled native uterus better. An innovative combination of two proteomic analyses revealed higher fibronectin and versican content in these porous scaffolds, which may explain the improved scaffold organization. Together with other important protocol-dependent differences, our results can contribute to the development of improved decellularization protocols for assorted organs. Furthermore, our study shows the first available data on decellularized whole uterus, and creates new opportunities for numerous in vitro and in vivo whole-uterus tissue engineering applications.

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