*Purpose: Uterine transplantation is a new surgical approach in transplantation community. It can be performed after living donation (LD) or Dead-Brain Donation (DBD). Static cold storage of uterus is the only standard method for preservation prior to transplantation. Pulsatile hypothermic machine perfusion (HMP) is an emerging method that could potentially improve the preservation of uterus to enhance graft preservation in the DBD context. To provide reassurance of organ, we propose that normothermic perfusion (NMP) of uterus after cold preservation allows necessary functional and physiological assessments.

*Methods: Porcine uterus was retrieved from animal house DBD model and flushed with IGL-1. After vascular preparation on back table, uterus was perfused by HMP through a canula in the aorta (Wave machine; Waters Medical Systems) for 100mn followed by 1h of NMP was achieved by Sorin Group extra-corporeal membrane oxygenation machine. Oxygenation was 21%. NMP parameters was a pressure of 40mmHg and temperature of 37°C. Perfusate was composed of red blood cells, plasma to provide a hematocrit of 25%, with additives of co-amoxiclav and 25,000IU of heparin.

*Results: The macroscopic appearance of the uterus at the end of HMP appeared viable (fig.1a) and was perfectly flushed. We observed a decrease of resistance index and an increase of perfusion flow at 20mn (Fig. 2). The assessment of the uterus vascularization after HMP preservation with normothermic reperfusion provide good perfusion and viability parameters during reperfusion (Fig. 1b, 1c).

*Conclusions: HMP seems to be feasible for uterine preservation in DBD porcine model. Normothermic perfusion is also a feasible method to allow physiological and vascularization assessment of uterus after preservation techniques encouraging us to further develop this model.

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