Mazzaferro V, Makowka L, Enrichens F, Kahn D, Ferla G, Banner B, Olivero G, Selby R R, Stevenson W C, Todo S
Department of Surgery and Pathology, University Health Center, Pittsburgh, PA.
J Invest Surg. 1989;2(3):293-303. doi: 10.3109/08941938909057435.
In this study kidneys were harvested from bred-for-research cats weighing 4 to 5 kg. General principles of donor bilateral nephrectomy en bloc with aorta, vena cava, renal vessels, and ureters were followed. After the harvest the grafts were placed in lactated Ringer slush. A cuff was prepared on the renal vein over a 10 French plastic tube. The aorta was divided and left in connection with the renal artery at each side. Twenty female checkered Flemish giant rabbits weighing 4.0-6.0 kg served as recipients. After premedication with 40 mg/kg of ketamine, anesthesia was maintained with repeated doses (every 10-15 min) of a 0.1-mL mixture of 5 parts ketamine and 1 part acepromazine diluted 50% in a normal saline. Arterial pressure, CVP, blood gases, and temperature were monitored. Through a limited midline incision a native left nephrectomy was performed. The venous anastomosis was performed with a cuff technique without clamping the vena cava (which causes severe hemodynamic instability); the anastomotic time was 2-3 min. The arterial anastomosis was performed with an end-to-side aorta-to-aorta anastomosis; the anastomotic time was 5 to 7 min. There were no episodes of venous or arterial thrombosis. The donor procedure took approximately 40 min, and the backtable preparation of the graft an additional 45 to 60 min. Preparation of the recipient for the anastomosis took 15 min and the anastomotic time (warm ischemia) was 13 +/- 5 min. In this model suitable for xenograft research the duration of the surgery in the recipient has been greatly reduced because of (1) the previous backtable preparation of the graft, and (2) the cuff technique used for venous anastomosis. The present anesthesia regimen and careful hemodynamic monitoring were also important in the success of this model.
在本研究中，从体重4至5千克的用于研究的猫身上获取肾脏。遵循供体双侧肾整块切除并连带主动脉、腔静脉、肾血管和输尿管的一般原则。获取后，将移植物置于乳酸林格液冰泥中。在肾静脉上套一个10法式塑料管制成袖套。将主动脉离断，每侧均保留与肾动脉相连。20只体重4.0至6.0千克的雌性花斑佛兰德巨兔作为受体。用40毫克/千克氯胺酮进行术前用药后，通过重复给予（每10 - 15分钟）0.1毫升由5份氯胺酮和1份乙酰丙嗪组成的混合物（在生理盐水中稀释50%）维持麻醉。监测动脉压、中心静脉压、血气和体温。通过有限的中线切口进行自体左肾切除术。静脉吻合采用袖套技术，不夹闭腔静脉（夹闭腔静脉会导致严重的血流动力学不稳定）；吻合时间为2 - 3分钟。动脉吻合采用端侧主动脉 - 主动脉吻合；吻合时间为5至7分钟。未发生静脉或动脉血栓形成。供体手术约需40分钟，移植物的后台准备额外需要45至60分钟。受体吻合准备需15分钟，吻合时间（热缺血）为13±5分钟。在这个适用于异种移植研究的模型中，由于（1）移植物先前的后台准备，以及（2）用于静脉吻合的袖套技术，受体手术的持续时间大大缩短。目前的麻醉方案和仔细的血流动力学监测对该模型的成功也很重要。
