Homotransplants of the testis

Effects of antioxidants, catalase and α-tocopherol on cell viability and oxidative stress variables in frozen-thawed mice spermatogonial stem cells

Cryopreservation of spermatogonial stem cells is considered as a useful procedure for preserving fertility in children with testis cancer. SSCs were isolated from testes mice, and then antioxidant was added to the freezing medium. The Bax expression level in antioxidant groups was significantly (P ≤ 0.05) lower than the control group and a significant rise of Bcl2 expression was detected in the antioxidant groups. ROS production with antioxidant was significantly lower compared with the control group. Cryopreservation with the addition of the antioxidants can help increase the number of SSCs and improve the quality and viability of these cells after cryopreservation.

The Penile Flap in the Rat

Considering both its unique structural and functional properties, the reconstruction of the penis is still a challenging problem in reconstructive surgery. Reconstruction may be required in many situations, including traumas, congenital abnormalities, and female-to-male transsexual surgery. Currently, the only natural reconstructive method for the penis is its microvascular reattachment in amputation cases. In all other situations, and in nonreplantable amputations, there is no alternative but to reconstruct the penis using autologous tissues to create the most similar substitute, hoping for a possible allogeneic transplantation in the future. There are many unresolved issues and unanswered questions related to functional recovery after replantation of the penis. In this study, to overcome these drawbacks and to guide and show the feasibility of allogeneic transplantation of the penis in humans in the future, we describe a penile composite tissue flap based on the internal pudendal artery and its autotransplantation in an economical animal species. Fifty adult male Sprague-Dawley rats weighing 400 to 500 g were used. In 20 rats, the vascular anatomy of the male perineal region was determined by anatomic dissections. Based on this anatomic study, the penile composite flap was created based on the internal pudendal vessels. In 10 rats, the penile flap was raised as an island flap based on its vascular pedicle and replaced in situ. In 10 rats, distant flap transfer was accomplished to determine the feasibility of the flap being transferred as a free flap and to demonstrate the viability of the flap components in a heterotopic region. For this purpose, the flap was transferred to the groin region performing anastomoses between internal pudendal vessels and superficial epigastric vessels. In the control group (n=10), while the same surgical procedure was performed, the flap was transferred to the groin region but no anastomosis was performed. The procedure required approximately 3 to 4 hours of operating time in the free flap group. Five of the animals died in the early postoperative days, while all others survived. Direct observation and microangiography were used to assess the viability of the flaps. On the basis of direct observation on the seventh postoperative day, all the pedicled flaps survived completely. In the free-flap group, all but 1 of the vascularized flaps showed complete survival, whereas all the nonvascularized flaps completely necrosed. The authors conclude that the penile flap of the rat offers the following advantages: (1) the composite tissue flap is harvested from a small animal species, (2) the flap is an exact representation of the clinical original penile composition, (3) it can be transferred as a free flap without the need for an isogeneic animal, (4) the vascular pedicle is consistent and allows for microvascular anastomoses. The flap will provide a means for future physiological studies, especially for replantation cases. The feasible autotransplantation of the penile flap with successful results will also guide researchers towards the future allogeneic transfer of the penis in humans.

Spermatogenesis following syngeneic testicular transplantation in Balb/c mice

Transplantation of spermatogonial stem cells in cross-species has been widely used to study the function of Sertoli cells and the effect of phylogenetic distance between donor and recipient animals on the outcome of spermatogonial transplantation, whereas there have been only a few reports on the transplantation of testis tissue. The objective of the present study was to examine the development of grafted testes and the kinetics of spermatogenesis following syngeneic testicular transplantation in both male and female recipient Balb/c mice in an effort to establish an in vivo culture system and to compare the effects of host sex on spermatogenesis. The testes from 5-day-old Balb/c mice were transplanted under the dorsal skin of four-week-old mice. Twenty male and twenty female Balb/c mice were used as the hosts and each host received 4 grafts. The recipient mice were killed at 1, 2, 3, 5, 7, 9, 12 and 15 weeks after transplantation. The graft survival rate and graft size were measured. The status of spermatogenesis was assessed by histological analyses. The expression of the spermatid-specific Protamine-2 gene was examined by RT-PCR. Overall, 70.3% of the testicular grafts in male hosts and 67.2% in female hosts survived. All recovered grafts had increased in volume, some of them had increased by more than 30-fold. The architecture of the seminiferous tubules in female hosts appeared to be better than that in male hosts. The round spermatids were the most advanced germ cells until 15 weeks after transplantation, and no complete spermatozoon was observed in any of the grafts. The expression of protamine-2 was detected in grafts from 5 weeks posttransplantation in both male and female hosts, confirming that the spermatogenic cells differentiated into spermatids. In contrast to grafts, the testes of male hosts had a normal histological appearance. The results showed the schedule of spermatogenesis following syngeneic testicular transplantation in both male and female hosts. This model could be useful for further studies involving the endocrinology of the testis and the mechanisms of spermatogenesis.

Transplantation of the testis; from the past to the present

Since the development of surgery, the possibility of testis transplantation has fascinated man for centuries. Hunter and Berthold are considered to be the most important investigators in this field and, in addition, to be the founders of modern endocrinology. The association of testis transplantation with rejuvenation led to widespread popularity for this treatment in the first three decades of the twentieth century. At the same time, controversies concerning the aim of the treatment have coloured the early years of endocrinology. In the 1960s renewed interest in the subject arose for experimental reasons, leading to the development of microsurgical techniques for autotransplantation of high-lying undescended testes in children. Homologous testis transplantation has never become a subject of great interest, probably for ethical reasons. This possible treatment for hypogonadism, however, has been developed experimentally and has been performed in man only in Russia and China, evidently with success. The details of these studies and their outcomes are discussed.

Transplantation of reproductive organs

A historical review of the literature concerning replantation and transplantation of reproductive organs has included studies from this laboratory, using rats, over the past 25 years. From the basic observation of ischemic and traumatic injury due to the transplantation, syngeneic testicle transplants, resulting in a partner's impregnation and histological restoration of the testicles, led to human testicular transplantation. As to the ovarian transplants, granulosa-theca cell tumors may transform into malignancies if followed for a prolonged period as intrasplenic ovaries, and high doses (15 to 20 mg/kg b.w.) of azathioprine can produce such malignant tumors in a shorter period. By caval-portal shunt, ovarian hormones enter directly into the portal blood stream and no typical granulosa-theca cell tumors were produced, owing to the fact that the liver cannot degrade all the hormones secreted by both ovaries. While en-bloc vagino-utero-ovarian transplantation in the rat is possible, no impregnation has been yet achieved. Finally, it is hypothesized that those who have acquired microsurgical techniques and have a full understanding of the anatomy of the reproductive system will not only be able to perform replantation of the penis, but also will be capable of allogeneic transplantation of genital organs, whether ethically approved or not, and sooner than one may think. In such cases a penile part may be obtained at a sex-change surgery or from a cadaveric donor, similar to other vital organ transplantation practices.