Techniques of orthotopic renal transplantation in pigs. One donor to two recipients via inverted grafting

Kinoshita, Yoshitaka; Iwami, Daiki; Fujimura, Tetsuya; Kume, Haruki; Yokoo, Takashi; Kobayashi, Eiji

doi:10.1590/acb360208

Cited by 5 publications

(7 citation statements)

References 11 publications

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“…However, with the conventional method, the transplanted kidney turned dark red, and the presence of venous congestion was suspected. These findings and the postoperative course suggested that transplants by the conventional method may be susceptible to torsion of the venous anastomosis due to body movements, which led us to decide on orthotopic transplantation to the natural locations of the renal artery and vein, which we previously reported in a pig-to-pig renal transplant 10 . The ingenuity of the orthotopic transplant method developed in this study lies in the use of the recipient's renal artery in xenotransplantation without immunosuppression; rather, vascular insufficiency occurred, as indicated by the findings of glomerular collapse and dissection of the renal tubules from the basal membrane (Figs.…”

Section: Discussionmentioning

confidence: 96%

“…Additionally, all renal xenotransplant experiments were approved by the animal ethics committee of the Jikei University School of Medicine (approval number: 2020-055). An expert surgeon (E.K), who have had more than fifty experiences of pig kidney transplantation, conducted the series of experiments 10 , 11 .…”

Section: Methodsmentioning

confidence: 99%

“…The donor surgery was performed as previously reported 10 . Briefly, after a full-length midline abdominal intraperitoneal incision, the left kidney was mobilized by finger dissection.…”

Section: Methodsmentioning

confidence: 99%

“…An earlier study of a pig-to-pig kidney transplant model described the detailed techniques of kidney grafts removed from one donor and transplanted into two recipients at the site of the left kidney 10 . In the current study, we matched the size of the kidneys between pig donors and monkey recipients, and detailed our method of transplanting the pig kidney to the natural position of the monkey’s kidneys.…”

Section: Introductionmentioning

confidence: 99%

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Techniques of orthotopic renal transplantation. II. Size-matched porcine grafts in monkey recipients

et al. 2021

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Purpose As a classical xenotransplantation model, porcine kidneys have been transplanted into the lower abdomen of non-human primates. However, we have improved upon this model by using size-matched grafting in the orthotopic position. The beneficial aspects and surgical details of our method are reported herein. Methods Donors were two newborn pigs (weighting 5 to 6 kg) and recipients were two cynomolgus monkeys (weighting, approximately, 7 kg). After bilateral nephrectomy, kidneys were cold-transported in Euro-Collins solution. The porcine kidney was transplanted to the site of a left nephrectomy and fixed to the peritoneum. Results Kidneys transplanted to the lower abdomen by the conventional method were more susceptible to torsion of the renal vein (two cases). In contrast, early-stage blood flow insufficiency did not occur in orthotopic transplants of theleft kidney. Conclusions Size-matched porcine-primate renal grafting using our method of transplanting tothe natural position of the kidneys contributes to stable post-transplant blood flow to the kidney.

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Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

“…The donor surgery was performed as previously reported 10 . Briefly, after a full-length midline abdominal intraperitoneal incision, the left kidney was mobilized by finger dissection.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Techniques of orthotopic renal transplantation. II. Size-matched porcine grafts in monkey recipients

et al. 2021

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“…As a result of the similar size of the kidney in swine and humans, the pig model is frequently chosen for research in the field of kidney transplantation and also for surgical training [59,80].…”

Section: Kidney Transplantationmentioning

confidence: 99%

Animal Models in Allogenic Solid Organ Transplantation

Wenzel¹,

Blasczyk²,

Figueiredo³

2021

Transplantology

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Animal models provide the link between in vitro research and the first in-man application during clinical trials. They provide substantial information in preclinical studies for the assessment of new therapeutic interventions in advance of human clinical trials. However, each model has its advantages and limitations in the ability to imitate specific pathomechanisms. Therefore, the selection of an animal model for the evaluation of a specific research question or evaluation of a novel therapeutic strategy requires a precise analysis. Transplantation research is a discipline that largely benefits from the use of animal models with mouse and pig models being the most frequently used models in organ transplantation research. A suitable animal model should reflect best the situation in humans, and the researcher should be aware of the similarities as well as the limitations of the chosen model. Small animal models with rats and mice are contributing to the majority of animal experiments with the obvious advantages of these models being easy handling, low costs, and high reproductive rates. However, unfortunately, they often do not translate to clinical use. Large animal models, especially in transplantation medicine, are an important element for establishing preclinical models that do often translate to the clinic. Nevertheless, they can be costly, present increased regulatory requirements, and often are of high ethical concern. Therefore, it is crucial to select the right animal model from which extrapolations and valid conclusions can be obtained and translated into the human situation. This review provides an overview in the models frequently used in organ transplantation research.

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A Novel Hypobaric Perfusion Method to Remove Microthrombi in Kidney Grafts with Prolonged Circulatory Arrest: A Pilot Study on a Porcine Model

Kinoshita,

Iwai,

Torai

et al. 2024

Transplantation Direct

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Background. Intragraft microthrombi prevent complete organ perfusion, thereby compromising the viability maintained by preservation solutions or machine perfusion. Herein, we developed and evaluated a hypobaric perfusion method for flushing microthrombi from kidney grafts with prolonged circulatory arrest in a porcine model. Methods. Porcine renal grafts with 1-h warm ischemia were flushed with heparin-containing perfusate in a normobaric environment (control group) or a hypobaric environment of −20 to −30 mm Hg (hypobaric perfusion group) for 10 min using a gravity drip from a 1-m height. Perfusion parameters, histological findings in ex vivo blood perfusion experiments (2 control and 4 hypobaric perfusion kidneys), and safety in allogeneic porcine transplantation experiments (1 donor to 2 recipients) were evaluated. Results. The −20 mm Hg hypobaric perfusion group exhibited greater maximal flow than the control group (20.4 versus 6.9 mL/min; P = 0.028). Histological evaluation following 3 h of static cold storage and 10 min ex vivo porcine whole-blood perfusion revealed statistically significant reductions in congestion and edema (1.5 versus 3, and 0.5 versus 4 on a 5-point scale, from 0 to 4; P = 0.014 and 0.006, respectively) in the medulla along with improved ischemia–reperfusion injury scores (4.0 versus 4.7 on a 6-point scale, from 0 to 5; P = 0.004) in the −20 mm Hg hypobaric perfusion group. Kidney grafts perfused under −30 mm Hg hypobaric environment followed by 3 h of static cold storage could be used for porcine allogeneic transplantation without any macroscopic damage to the graft, effect on intraoperative handling, or perioperative adverse events. Thus, the hypobaric perfusion method was considered safe. Conclusions. Perfusion in a hypobaric environment may prevent graft congestion, edema, and further reperfusion injury by flushing out erythrocytes occluding the medullary capillaries, improving marginal renal graft quality, and reducing the number of discarded grafts.

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Techniques of orthotopic renal transplantation in pigs. One donor to two recipients via inverted grafting

Cited by 5 publications

References 11 publications

Techniques of orthotopic renal transplantation. II. Size-matched porcine grafts in monkey recipients

Techniques of orthotopic renal transplantation. II. Size-matched porcine grafts in monkey recipients

Animal Models in Allogenic Solid Organ Transplantation

A Novel Hypobaric Perfusion Method to Remove Microthrombi in Kidney Grafts with Prolonged Circulatory Arrest: A Pilot Study on a Porcine Model

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