Soma T, Lerut E, Billiau A, Waer M, Goebels J, Koshiba T, Uemoto S, Pirenne J
Department of Abdominal Transplant Surgery, University Hospitals Leuven, 3000 Leuven, Belgium.
Transplant Proc. 2009 Oct;41(8):3422-4. doi: 10.1016/j.transproceed.2009.09.027.
Kidney transplantation in rats is an important research model. Various methods have been reported, but there is no "standard operation." We investigated a 1-stage versus a 2-stage native nephrectomy and the type of ureteral anastomosis seeking to establish a standard, reproducible and successful method.
We used PVG (RT1c-RT1Ac: B/Dc) male rats, weighing approximately 200 to 250 g, that underwent transplantation after right recipient nephrectomy. Left recipient nephrectomy was performed either 10 days later or simultaneously. The ureteric anastomosis was fashioned 2 ways: using a ureteral stent or by bladder insertion.
Urinary complications (obstruction or reflux) were observed in 77.8% when a ureteral stent was used for the ureteric anastomosis versus 28.6% when using the bladder insertion technique (P = .0211). Transplanted rats with nephrectomy of both native kidneys at the time of grafting showed a perioperative mortality of 70%, whereas those hosts with a 2-stage nephrectomy displayed a mortality rate of 22% (P = .0025).
The bladder insertion technique reduced the incidence of urological complications in rats. In addition, unilateral native nephrectomy at the time of operation with delayed contralateral nephrectomy was better tolerated than simultaneous bilateral nephrectomy. These 2 surgical variants allowed us to perform kidney transplantation with a high degree of success.
大鼠肾移植是一种重要的研究模型。已有多种方法被报道,但尚无“标准术式”。我们研究了一期与二期原位肾切除术以及输尿管吻合方式,旨在建立一种标准、可重复且成功的方法。
我们使用体重约200至250克的PVG(RT1c - RT1Ac: B/Dc)雄性大鼠,在右侧受体肾切除术后进行移植。左侧受体肾切除术在10天后或同时进行。输尿管吻合采用两种方式:使用输尿管支架或膀胱植入。
输尿管吻合使用输尿管支架时,观察到77.8%的大鼠出现泌尿系统并发症(梗阻或反流),而采用膀胱植入技术时这一比例为28.6%(P = 0.0211)。移植时双侧原位肾均被切除的大鼠围手术期死亡率为70%,而二期肾切除术的宿主死亡率为22%(P = 0.0025)。
膀胱植入技术降低了大鼠泌尿系统并发症的发生率。此外,手术时行单侧原位肾切除术并延迟对侧肾切除术比同期双侧肾切除术耐受性更好。这两种手术方式使我们能够高度成功地进行肾移植。