Golriz M, Fonouni H, Nickkholgh A, Hafezi M, Garoussi C, Mehrabi A
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Eur Surg Res. 2012;49(3-4):121-9. doi: 10.1159/000343132. Epub 2012 Nov 21.
Swine and human beings have many aspects in common that make swine a well-characterized large animal model for kidney transplantation (KTx). However, pigs have some peculiar anatomical characteristics that standardized techniques must adapt to. The aim of this study was to prepare an up-to-date guideline for porcine KTx.
To achieve this goal, we performed a Medline search using the terminology 'kidney' or 'renal' and 'transplantation' and 'pig' or 'swine' or 'porcine'. We found over 1,300 published articles since 1963. Only 13 studies focused on the surgical aspect. Furthermore, we reviewed related books and articles about swine anatomical characteristics and surgery. Finally, our experimental experiences of KTx during the last few decades were added to this collection.
Proper hosting, fasting, anesthesia, medical therapy and monitoring can prevent postoperative complications. Explantation with a Carrel patch of the aorta facilitates the implantation and prevents future stenosis. Native nephrectomy makes the follow-up of the implanted organ more precise. KTx in the infrarenal fossa via end-to-side anastomosis to the aorta and inferior vena cava followed by ureteroureterostomy are the recommended options for KTx in pigs compared to other possible methods.
Pigs, with respect to their characterizations, constitute one of the best large animal models for KTx. Preoperative preparations are as important as the intra- and postoperative management. Using the most adaptable methods of surgery with respect to the specific anatomical characteristics of pigs can prevent undermining the studies and avoid preventable complications and pitfalls.
猪和人类在许多方面具有共性，这使得猪成为一种特征明确的肾脏移植（KTx）大型动物模型。然而，猪具有一些独特的解剖学特征，标准化技术必须与之相适应。本研究的目的是制定一份最新的猪肾脏移植指南。
为实现这一目标，我们使用“肾脏”或“肾”以及“移植”和“猪”或“ swine”或“ porcine”等术语在Medline上进行检索。我们发现自1963年以来有超过1300篇已发表的文章。只有13项研究关注手术方面。此外，我们查阅了有关猪解剖学特征和手术的相关书籍及文章。最后，我们将过去几十年间肾脏移植的实验经验也纳入了这一资料集。
适当的饲养、禁食、麻醉、药物治疗和监测可预防术后并发症。带主动脉卡雷尔补片的肾外植有助于植入并防止未来的狭窄。切除自体肾脏可使对植入器官的随访更精确。与其他可能的方法相比，经腹主动脉端侧吻合和下腔静脉吻合后行输尿管输尿管吻合术将肾脏移植到肾下窝是猪肾脏移植的推荐方法。
就其特征而言，猪是肾脏移植的最佳大型动物模型之一。术前准备与术中和术后管理同样重要。针对猪的特定解剖学特征采用最具适应性的手术方法可避免破坏研究，并避免可预防的并发症和陷阱。
