Vein "Beltization" Technique Facilitates Venous Anastomoses for Laparoscopic Orthotopic Kidney Transplantation in a Pig Model.

OBJECTIVE

This study was performed to investigate the safety and efficiency of the renal vein "beltization" technique for laparoscopic orthotopic kidney transplantation (LOKT) in a pig model.

MATERIAL AND METHODS

Kidney autotransplants were conducted, in which the renal vein beltization technique was employed, in 12 domestic pigs. In the operation, the right kidney was autotransplanted to the left kidney vessel trunks. Data of the operative time, venous anastomotic time, vein stenosis, blood loss, kidney graft function, and survival for the pigs were recorded. One week later, the transplanted autograft was removed for observation from the surviving animals while under anesthesia. A silicon tube cage was used to induce hypothermia during laparoscopic operation.

RESULTS

All 12 LOKTs were finished. The mean warm ischemia time was 5.22 ± 1.33 minutes, and the mean cold ischemia time was 263.44 ± 50.82 minutes. The mean transplant operative time was 305.67 ± 30.88 minutes. The venous and arterial anastomotic times were 68.42 ± 8.51 minutes and 40.92 ± 9.83 minutes, respectively. After revascularization, an immediate and viable blood supply was seen in 7 grafts based on the appearance of a bright red color. Four pigs urinated immediately after the operation, and 3 produced urine on the next day; 4 pigs received life-supporting renal autografts for 7 days. Autopsy results showed 3 artery stenoses and 3 vein stenosis. Thrombi were found in all of these strictured vessels. The median survival time of the pigs was 5.55 days.

CONCLUSIONS

The renal vein beltization technique may facilitate laparoscopic pig venous anastomotic procedures and ensures the quality of reconstruction. It is helpful for venous anastomoses in LOKT.