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The Bioengineered Uterus: A Possible Future

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Book cover Uterus Transplantation

Abstract

Customized grafts that include a scaffold populated with the patient’s own cells could become a major advantage in the field of uterus transplantation since it may overcome problematic donor issues and negative side effects from immunosuppression. So far, bioengineering was only utilized to personalize bone structure grafts and less complex organs for clinical use. However, recent tissue engineering protocols developed in animal experiments now include solid tissues and whole organs that were decellularized to create suitable scaffolds for using autologous stem cells in the reconstruction phase. Furthermore, several studies have shown that stratified uterine-like tissues can successfully be created in vitro either from various collagen-derived hydrogels or from decellularized uterine tissues populated with primary cells of the uterus and mesenchymal stem cells. When patches of these constructs were assessed in rodent models, that carried uteri with defect uterine walls, they stimulated regeneration and significantly improved fertility outcomes. Hence, partial uterus repair using a bioengineered construct could potentially become an effective treatment routine to cure infertility or fetal morbidity caused by severe uterus scarring or malformations. However, improved protocols are still needed that will support the construction of a transplantable bioengineered whole uterus. These large constructs must be constructed to enable vascular anastomosis and must facilitate successful implantation and fetal development. Once these objectives are met, this donor option could become a future clinical reality in a uterus transplantation setting.

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Abbreviations

3D:

Three-dimensional

ECM:

Extracellular matrix

ES:

Embryonic stem (cells)

GFP:

Green fluorescent protein

HHP:

High hydrostatic pressure

iPS:

Induced pluripotent stem (cells)

MSCs:

Mesenchymal stem cells

SDS:

Sodium dodecyl sulfate

STAT3:

Signal transducer and activator of transcription 3

UTx:

Uterus transplantation

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Acknowledgements

The authors report no conflict of interest. The work was supported by Wilhelm and Martina Lundgren research foundation, Hjalmar Svensson research foundation, Adlerbertska research foundation, the Swedish Government LUA grant, Wallenberg Foundation and the Swedish Science Research Council (Vetenskapsrådet; Grant No. 116008).

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Authors and Affiliations

  1. Laboratory for Transplantation and Regenerative Medicine, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Mats Hellström & Mats Brännström

  2. Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Mats Hellström & Mats Brännström

  3. Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden

    Mats Hellström & Mats Brännström

  4. Stockholm IVF-EUGIN, Stockholm, Sweden

    Mats Brännström

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Correspondence to Mats Hellström .

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  1. University of Gothenburg, Gothenburg, Sweden

    Mats Brännström

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Hellström, M., Brännström, M. (2020). The Bioengineered Uterus: A Possible Future. In: Brännström, M. (eds) Uterus Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-94162-2_29

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  • DOI: https://doi.org/10.1007/978-3-319-94162-2_29

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