Zhang G, Zhao H, Sun Z-Y
Department of Urology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing 210008, Jiangsu Province, China.
Eur Surg Res. 2010;44(1):37-42. doi: 10.1159/000262607. Epub 2009 Dec 2.
To reduce warm ischemic time and avoid irreversible damage to the graft in rat kidney transplantation.
After left nephrectomy, recipients were transplanted with syngeneic kidney grafts using microsurgical techniques. In control rats (n = 20), the renal artery anastomoses were performed with 8-9 interrupted sutures by the conventional technique. In experimental animals (n = 20), a modified anastomosis was performed using fewer (5-6) sutures and fibrin glue devoid of thrombin.
The number of sutures in the control group was 8.09 + or - 0.35 while that in the experimental group was 5.65 + or - 0.48 (p < 0.01). The warm ischemic time reduced from 29.7 + or - 1.1 min in the control group to 23.9 + or - 0.9 min in the experimental group (p < 0.01). These anastomoses maintained adequate patency rates and mechanical strength. Up to 21 days after operation, the graft survival rates in the experimental and control groups were 90 and 85%, respectively.
Our modified technique for renal artery anastomosis significantly reduced the warm ischemic time in rat kidney transplantation. This technique would be a safe and reliable method for rat renal artery anastomosis as well as for other microarterial anastomoses, particularly for novice surgeons.
在大鼠肾移植中减少热缺血时间并避免移植物发生不可逆损伤。
在切除左肾后，采用显微外科技术将同基因肾移植物移植给受体。在对照组大鼠（n = 20）中，采用传统技术用8 - 9针间断缝合进行肾动脉吻合。在实验组动物（n = 20）中，采用改良吻合术，使用较少（5 - 6针）的缝线并使用不含凝血酶的纤维蛋白胶。
对照组的缝线数为8.09 ± 0.35，而实验组为5.65 ± 0.48（p < 0.01）。热缺血时间从对照组的29.7 ± 1.1分钟减少至实验组的23.9 ± 0.9分钟（p < 0.01）。这些吻合术保持了足够的通畅率和机械强度。术后长达21天，实验组和对照组的移植物存活率分别为90%和85%。
我们改良的肾动脉吻合技术显著减少了大鼠肾移植中的热缺血时间。该技术对于大鼠肾动脉吻合以及其他微动脉吻合而言将是一种安全可靠的方法，尤其对于新手外科医生。
