Wenwei Chen, Yirong Yang, Stevens Katarzyna M, Heger Michal, Peng Xia
Department of Transplantation, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village, Ouhai District, 325000 Wenzhou, Zhejiang P. R. China.
Live Cell Imaging Facility, Snyder Institute for Chronic Diseases, University of Calgary, Calgary, Alberta Canada.
Eur Surg. 2017;49(1):17-22. doi: 10.1007/s10353-016-0391-7. Epub 2016 Jun 9.
This study aimed to introduce an improved surgical procedure to reduce the incidence of urinary tract complications after renal transplantation in mice using a modified bladder patch-to-bladder anastomosis technique.
Renal isotransplantation was performed in 28 male C57BL/6 mice. The urinary tract was reconstructed with a ureteral anastomosis between the donor's small bladder patch and the recipient's bladder. The bladder patch was secured through a cystotomy in the recipient's bladder mucosa and seromuscular layers, which were sutured in a double-layer manner. The food intake and survival of mice were recorded for 100 days in addition to monitoring appearance, weight, and symptoms of pain. On post-transplantation day 7, the native kidney in the recipients was removed and the transplanted kidney assessed visually. Urine leakage from the transplanted graft was monitored by assessing the degree of ascites.
The success rate of renal transplantation was 82 % (23 of 28 cases). Arterial thrombosis at the site of anastomosis occurred in 3 cases (11 %) and hemorrhagic shock in 2 cases (7 %). The mean ± SD time of the operation in recipients was 81 ± 5 min. No complications were noted in the successfully transplanted animals.
The modified procedure of a small bladder patch-to-bladder with double-layer suturing minimizes complications after renal transplantation in mice while requiring the same operating time as other approaches such as ureter to bladder anastomosis, which are associated with more complications.
本研究旨在引入一种改良的手术方法，通过改良的膀胱补片与膀胱吻合技术，降低小鼠肾移植后泌尿系统并发症的发生率。
对28只雄性C57BL/6小鼠进行肾同基因移植。通过将供体的小膀胱补片与受体的膀胱进行输尿管吻合来重建尿路。膀胱补片通过受体膀胱黏膜和浆肌层的膀胱切开术固定，采用双层缝合。除了监测小鼠的外观、体重和疼痛症状外，还记录了100天内小鼠的食物摄入量和存活率。在移植后第7天，切除受体的天然肾脏并对移植肾进行肉眼评估。通过评估腹水程度监测移植肾的尿液渗漏情况。
肾移植成功率为82%（28例中的23例）。吻合部位发生动脉血栓形成3例（11%），出血性休克2例（7%）。受体的平均手术时间±标准差为81±5分钟。成功移植的动物未出现并发症。
改良的小膀胱补片与膀胱双层缝合手术方法，在小鼠肾移植后并发症最少，同时与输尿管与膀胱吻合等其他并发症较多的方法所需手术时间相同。
