Primates are physiologically and anatomically similar to humans, and thus our results are potentially important for clinical application of UTx in humans. Postoperative management for primates differs from that for humans. Because the appropriate Selleckchem Z VAD FMK concentration of tacrolimus in organ transplantation in cynomolgus monkeys is generally higher than that in humans, we used a higher concentration than that used in humans. It is also

difficult to perform continuous infusion, which made it more difficult to control the blood tacrolimus concentration, which had to be stabilized by p.o. administration. Blood tacrolimus decreased 1–2 weeks after surgery due to anorexia, and gastrointestinal absorption was also poor after surgery, with evidence of possible rejection found in both cases. Because low blood concentrations and rejection were observed, the dose of immunosuppressants was increased. The general condition and appetite

then gradually improved and at 3 weeks the tacrolimus level rapidly increased, perhaps due to enhanced gastrointestinal absorption of the drug. Thus, it was extremely difficult to control the blood concentrations of oral tacrolimus in the cynomolgus monkeys. Furthermore, a limitation of Staurosporine cell line the study was that tacrolimus could not be determined in the test facility and this test was commissioned to an external institution. Consequently, the results had a time lag of several days. This caused further difficulty with the blood concentration control. Rejection diagnosis in solid organ transplantation is mostly performed by biopsy. However, there is no clear procedure for monitoring rejection in UTx. In transplantation of other organs, information Rapamycin mouse on organ dysfunction is obtained from blood samples. However, the uterus is not a vital organ and blood tests cannot be used to determine rejection. Therefore, we used Duplex/Doppler echo and pathological findings

from biopsy of the uterine cervix to monitor possible rejection. Echo findings show whether blood flow in the uterine artery after microvascular anastomosis is decreased by stenosis or thrombus. In case 2, echo immediately after surgery showed blood flow in the right and left uterine arteries, but flow in the right uterine artery could not be detected after 1 month and there was no flow in both uterine arteries after 2 months, because case 2 did not recover from rejection. Moreover, temporal enlargement of the uterus was observed in case 2 on POD 23. This may be a mechanism of rejection similar to that of renal enlargement observed in renal transplantation. Pathological findings show that both animals had initial rejection.