Rat lung transplantation model: modifications of the cuff technique

Abstract

Background: Although the cuff technique in rat lung transplantation (LTx) has a long history, it remains technically challenging. We have developed key tricks and modifications in the devices and the cuff technique that optimize the rat LTx model to achieve successful operations during a short learning period. Methods: Altogether, 180 consecutive rats underwent orthotopic left LTx performed by a single surgeon using our modified devices and procedures. Allogeneic and syngeneic transplantation were performed using Lewis rats as recipients and Brown Norway and Lewis rats as donors. Allogeneic recipients were treated with cyclosporine during the first week. Recipients were sacrificed at various time points after ≥2 weeks. Results: A special cuff-preparation plate was created using a petri dish and two foam blocks. This modified plate stabilizes the preparation and prevents donor lung compression. A "┴"-shaped incision was carved into the front wall of the pulmonary artery (PA) using micro-scissors. "V"-shaped incisions were made from the inferior-to-superior branches of the pulmonary vein (PV) and bronchus. A "pendulum model" was applied at implantation to make the hilar anastomosis tension-free and technically easier to perform. There were no intraoperative complications. Ten rats (5.6%) experienced partial or full pulmonary atelectasis. Five deaths (2.8%) due to pleural effusion occurred during the follow-up period. The operative times for heartlung block retrieval, cuff preparation, cold ischemia, warm ischemia, and total procedure time were 8. 4±0.8, 11.6±1.5, 25.1±2.2, 8.1±1.2, and 46.7±2.8 min, respectively. Conclusions: The key tricks and improvements we made in the cuff technique for rat LTx provided the advantages of expeditiousness, a low complication rate, and a high success rate.

Improvement of surgical techniques for orthotopic single lung transplantation in rats

“…Therefore, in the present study, inspired by the Rummel tourniquet used for transient pulmonary artery occlusion in video-assisted thoracoscopic surgery (22), a small Rummel for the rat was fashioned with The Rummel tourniquet was also used for hilar occlusion in a murine model of left lung ischemia reperfusion injury (23). Whether chest drainage is necessary has remained controversial in previous reports (8,24). However, postoperative pneumothorax and pleural effusion are major risk factors of death after successful transplantation.…”

“…The rat orthotopic lung transplantation model is an important tool to investigate ischemia reperfusion and graft rejection; however, the procedure has remained challenging, with high failure rate. Despite some surgical improvements in rat lung transplantation have previously been reported in the literature (7,8), we are the first group to focus on how might more stable and more widely available anastomoses be achieved. By utilizing the approach reported in this article, the difficulty of the anastomoses of the pulmonary artery and vein can be reduced greatly, which were once thought to be the most challenging part.…”

“…Later in 1989, the cuff techniques were introduced by Mizuta et al (5), which dramatically facilitated anastomoses of the pulmonary artery and vein. Although a variety of modifications of surgical and cuff techniques have since been established (6)(7)(8), the rat transplantation model is still highly demanding and can only be performed successfully in select laboratories (9)(10)(11)(12).…”

Right lung transplantation with a left-to-right inverted anastomosis in a rat model

“…Most of the reagents, small handheld microsurgical instruments, and larger equipment for left LTx in rats have been described by us previously. 14 The material supplier for the current study differs from that used previously. Some important homemade devices were introduced in our technique.…”

“…The orthotopic left LTx in rats was consistent with that in our previous study, which modified the traditional left LTx model in diverse aspects. 14 …”