Esmaeilzadeh Majid, Sadeghi Mahmoud, Heissler Hans E, Galmbacher Roland, Majlesara Ali, Al-Afif Shadi, Mehrabi Arianeb
Department of Neurosurgery, Hannover Medical School, Hannover, Germany.
Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
J Invest Surg. 2020 Feb;33(2):141-146. doi: 10.1080/08941939.2018.1480677. Epub 2018 Oct 18.
Experimental animal research has been pivotal in developing clinical kidney transplantation (KTx). One donor-associated risk factor with negative affect of transplantation outcome is brain death (BD). Many rat models for BD and KTx have been developed in the last decade, but no surgical guidelines have been developed for these models. Here, we describe a surgical technique for BD induction and the cuff technique for experimental KTx in rats. After intubation and mechanically ventilation of sixteen healthy adult male Sprague-Dawley rats were induction of BD performed. Animals were kept hemodynamically stable for eight hours. Then, the kidney was prepared and perfused with standard histidine-tryptophan-ketoglutarate solution. After explantation, grafts were immediately implanted in recipients using the cuff technique and reperfused. After 2 h of observation, animals were sacrificed by intravenous administration of potassium chloride. In the early phase of BD, heart rate increased and mean arterial pressure decreased. Partial variations were observed in O partial pressure, O saturation, and HCO. During the 2-h observation phase, all transplanted kidneys were sufficiently perfused macroscopically. There was no hyperacute rejection. It is feasible to observe BD for 8 h with maintained circulation in small experimental settings. The cuff technique for KTx is simple, the complication rate is low, and the warm ischemia time is short, therefore, this could be a suitable technique for KTx in the rat model.
实验动物研究在临床肾移植（KTx）的发展中一直起着关键作用。脑死亡（BD）是一种对移植结果有负面影响的供体相关危险因素。在过去十年中，已经开发了许多用于BD和KTx的大鼠模型，但尚未为这些模型制定手术指南。在此，我们描述一种在大鼠中诱导BD的手术技术和用于实验性KTx的袖套技术。对16只健康成年雄性Sprague-Dawley大鼠进行插管和机械通气后，进行BD诱导。使动物血流动力学稳定8小时。然后，制备肾脏并用标准组氨酸-色氨酸-酮戊二酸溶液灌注。取出后，立即使用袖套技术将移植物植入受体并进行再灌注。观察2小时后，通过静脉注射氯化钾处死动物。在BD早期，心率增加，平均动脉压降低。在氧分压、氧饱和度和碳酸氢根方面观察到部分变化。在2小时观察期内，所有移植肾脏在宏观上均得到充分灌注。没有超急性排斥反应。在小型实验环境中维持循环观察BD 8小时是可行的。KTx的袖套技术简单，并发症发生率低，热缺血时间短，因此，这可能是大鼠模型中KTx的合适技术。
