He B, Musk G C, Mou L, Waneck G L, Delriviere L
Sir Charles Gairdner Hospital, Western Australia Liver-Kidney Transplant Service, Perth, Australia.
Transplant Proc. 2013 Jun;45(5):1776-9. doi: 10.1016/j.transproceed.2013.01.056.
Laparoscopic surgery has rapidly expanded in clinical practice replacing conventional open surgery over the last three decades. Laparoscopic donor nephrectomy has been favored due to its multiple benefits. The aim of this study was to explore the safety and feasibility of kidney transplantation by a laparoscopic technique in a pig model.
The study was approved by the university animal ethics committee. Eight female pigs (Sus Scrofra, weighing 45-50 kg) were divided into 2 groups: group I included 4 animals that underwent laparoscopic kidney orthotopic transplantation on the left side. The right kidney was remained functional in situ. The pigs recovered and were observed for 1 week. In the 4 hosts group II pigs underwent a laparoscopic kidney transplantation on the left side. With simultaneous clipping of the right ureter. After recovery, the pigs were observed for 4 weeks. A laparotomy for examination was performed prior to euthanasia.
All 4 group I pigs survived for 1 week. The laparotomy showed normal graft perfusion with wall patent renal artery and vein as well as satisfactory urine output upon transection of ureter in 3 hosts. Renal artery stenosis occurred in one pig. In The Immediate kidney graft function was achieved in 3 group II pigs. The fourth died following extubation due to laryngospasm despite a functional graft. The average creatinine levels were 195.5 μmol/L on day 3; 224.5 μmol/L at week 1; 127 μmol/L at week 2; 182.7 umol/L at week 3; and 154.7 umol/L at week 4.
Laparoscopic kidney transplantation was feasible and safe in a pig model with immediate graft function. This study will provide further evidence to support application of laparoscopic technique to human kidney transplant.
在过去三十年中，腹腔镜手术在临床实践中迅速发展，取代了传统的开放手术。腹腔镜供肾切除术因其诸多优点而受到青睐。本研究的目的是探讨在猪模型中采用腹腔镜技术进行肾移植的安全性和可行性。
本研究经大学动物伦理委员会批准。八只雌性猪（体重45 - 50千克的家猪）被分为两组：第一组包括4只接受左侧腹腔镜原位肾移植的动物。右侧肾脏保持原位功能。猪恢复后观察1周。在第二组的4只宿主猪中，左侧进行腹腔镜肾移植。同时夹闭右侧输尿管。恢复后，观察猪4周。在安乐死之前进行剖腹检查。
第一组的4只猪均存活1周。剖腹检查显示移植肾灌注正常，肾动脉和静脉壁通畅，3只宿主在切断输尿管后尿量令人满意。一只猪发生肾动脉狭窄。第二组的3只猪立即实现了移植肾功能。第四只猪尽管移植肾功能良好，但拔管后因喉痉挛死亡。第3天平均肌酐水平为195.5μmol/L；第1周为224.5μmol/L；第2周为12�μmol/L；第3周为182.7μmol/L；第4周为154.7μmol/L。
在猪模型中，腹腔镜肾移植是可行且安全的，移植肾功能立即恢复。本研究将提供进一步证据支持腹腔镜技术应用于人类肾移植。
