Department of Surgery, Laboratory of Experimental Surgery, Research Center, CHUM, Notre-Dame Hospital, University of Montreal, Quebec, Canada.
Microsurgery. 2010 May;30(4):327-31. doi: 10.1002/micr.20740.
Surgical complications are important causes of graft loss in the nonhuman primate kidney transplantation model. We reviewed the incidence and intervention methods in 182 kidney transplantations performed in our lab recently 2 years in Cynomolgus monkeys. There were six renal artery thromboses (3.3%), eight urine leakages (4.4%), and five ureteral stenoses (2.7%). All renal artery thrombosis cases were found within 3 days after surgery. Urine leakage appeared from the 5th to 12th day after surgery and all cases were caused by ureter rupture. Reexploration was performed in five cases to reanastomose ureter with stent. Four cases reached long-term survival. The rest one died of graft rejection. Ureteral stenoses were found in long-term survival cases. Ureter reanastomoses with stent were performed in two cases. The postoperative renal functions of these two monkeys recovered to normal and they survived until study termination. From this large number of study, our experience indicated that kidney transplantation in the nonhuman primate is a safe procedure with low complications. Reexploration is recommended for salvage of the graft with urine leakage and ureteral stenosis.
手术并发症是非灵长类动物肾移植模型中导致移植物丢失的重要原因。我们回顾了最近 2 年内本实验室在食蟹猴中进行的 182 例肾移植手术的发生率和干预方法。有 6 例（3.3%）发生肾动脉血栓形成，8 例（4.4%）发生尿漏，5 例（2.7%）发生输尿管狭窄。所有肾动脉血栓形成均发生在术后 3 天内。尿漏发生在术后第 5 至 12 天，均由输尿管破裂引起。5 例进行了再次探查，通过支架重新吻合输尿管。4 例达到长期存活。另 1 例死于移植物排斥。在长期存活的病例中发现了输尿管狭窄。对其中 2 例进行了带支架的输尿管再吻合术。这两只猴子术后肾功能恢复正常，存活至研究结束。从这项大量的研究中，我们的经验表明，非灵长类动物的肾移植是一种安全的手术，并发症发生率较低。对于尿漏和输尿管狭窄导致的移植物丢失，建议进行再次探查。
