Han X, Zhao Y, Zhu X, Li T, Li Y, Zhang P, Chen Y, Li G, Zhang X, He B
Institute of Urology, Capital Medical University, Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Department of Urology, Taian City Central Hospital, Shangdong Province, Taian City, China; School of Clinical Medicine, Tsinghua University, Beijing, China.
Transplant Proc. 2019 Apr;51(3):913-918. doi: 10.1016/j.transproceed.2019.01.034. Epub 2019 Jan 9.
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.
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.
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.
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.
本研究旨在探讨肾静脉“套带术”在猪模型腹腔镜原位肾移植（LOKT）中的安全性和有效性。
对12头家猪进行自体肾移植，采用肾静脉套带术。手术中，将右肾自体移植至左肾血管主干。记录猪的手术时间、静脉吻合时间、静脉狭窄、失血量、肾移植功能及存活情况。一周后，对存活动物在麻醉状态下取出移植的自体肾进行观察。在腹腔镜手术期间使用硅胶管笼诱导低温。
12例LOKT均顺利完成。平均热缺血时间为5.22±1.33分钟，平均冷缺血时间为263.44±50.82分钟。平均移植手术时间为305.67±30.88分钟。静脉和动脉吻合时间分别为68.42±8.51分钟和40.92±9.83分钟。血管再通后，7例移植肾根据鲜红色外观可见即时且可行的血供。4头猪术后立即排尿，3头猪第二天排尿；4头猪接受了为期7天的支持生命的自体肾移植。尸检结果显示3例动脉狭窄和3例静脉狭窄。在所有这些狭窄血管中均发现血栓。猪的中位生存时间为5.55天。
肾静脉套带术可能有助于腹腔镜猪静脉吻合手术，并确保重建质量。它有助于LOKT中的静脉吻合。
