Investigation of the preservative effect of N-acetyl-carnitine added to hystidine-triptophane-ketogluterate (HTK) solution in donor uterus

SUMMARYAt the present day, transplantation of the uterus in women with uterine factor infertility is seen as an alternative to fertility.Some changes may occur during the organ transplantations, removal of the organ from the body, preservation of the organ, and the transportation of the organ. In order to protect the viability and the metabolism of the donor organ and to reduce the ischemia-reperfusion injury after transplant, some protection solutions have been developed during the transferred period of the organ donor to the receiver. The results of a large number of the relevant literature studies about different solutions used in transplantation show that ischemia-reperfusion injury can not be prevented completely. In this study, the potential protective effect of antioxidant agent acetyl L-carnitine which is added into the solutions of cold storage histidine tryptophan ketoglutarate (HTK) on uterine tissue was investigated.For this purpose, hematoxylin-eosin (H&E) staining was made for the histological analysis, TUNEL method was used to determine DNA fragmentation, TBARS, CAT and NOS were measured in order to determine lipid peroxidation for biochemical analyzes. 24 Wistar albino rats were divided into 4 groups randomly. Rat uteruses of first group were stored 4 hours in 4 oC cold period of HTK solution, tissues in second group were stored 4 hours in 4 oC HTK+ acetyl L-Carnitine solution, tissues in third group were stored 24 hours in 4 oC HTK solution, uteruses in fourth group were stored 24 hours in 4 oC HTK+ acetyl L-Carnitine solution.In histological examination, Ischemia reperfusion injury was held in uteruses waited in HTK solution for 4 hour and 24 hour cold periods. Subepithelial inflammation, intraepithelial inflammatory cells, stromal and intramuscular fibroblastic granulosa tissue and apoptotic bodies in endometrial glands and stroma, eosinophilic plasma cells in superficial and deep stroma, impaired muscle integrity were ischemic findings increased in time. In the uteruses held 4 hours in HTK + Acetyl L-carnitine solution, surface epithelium and subepithelial region was in normal histological form. However, in the endometrial glandular cells and stroma of the gland peripheral apoptotic cells were observed in this group. In tissues held in HTK+acetyl L-carnitine solution for 24 hours subepithelial inflammation is less than all other groups, muscle integrity is maintained, the areas of fibroblastic granulosa were not occurred, , inflammatory cells and apoptotic cells in the epithelial cells of endometrial glands were seen as less common. In addition, the density of plasma cells in the superficial and deep stromal area was less than all other groups.In HTK groups, while the number of TUNEL positive cells increased parallel to time, it is determined that in experimental groups in which Acetyl L-carnitine is added to HTK solution the number of positive cells decrease in the long term application. It is determined that in HTK groups and in 4 hours HTK +Acetyl L-Carnitine groups lipid peroxidation was high while in the HTK+Acetyl-L-carnitine long term grup decreased. When HTK groups compared differences in CAT values, in the long term groups increase in CAT values was observed. However, when the short term acetyl L-carnitine added group and long term acetyl L-carnitine added group compared, CAT values were higher in the short term than long term. NOS values of HTK groups showed increase in parallel with time. It is observed that when the short and long period of Acetyl L-Carnitine application compared, NOS values increased in long term.As a result, it is determined that compared with HTK solutions used in organ transplantation, protective effect of Acetyl L-Carnitine added to HTK solutions in uterus is more and this protective effect is more dominant in long term.