Zhang Min, Zheng Xin, Zhang Xin, Zhang Zijian, Wang Xin, Hu Xiaopeng
Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Institute of Urology, Capital Medical University, Beijing, China.
Transl Androl Urol. 2022 Apr;11(4):439-450. doi: 10.21037/tau-21-1016.
Multiple porcine models have been established to study the mechanisms regarding kidney transplantation. With the development of xenotransplantation, the demand for a low weight miniature pig model has been increasing. A reliable and reproducible surgical technique to establish these models, and to address possible obstacles, has not been sufficiently defined in detail. The goal of the present study was to develop and optimize a low weight miniature pig porcine kidney transplantation model, including a comprehensive surgical description.
Eight male Bama miniature pigs (12-15 kg) were randomly chosen as kidney donors and, to facilitate investigation of the transplanted kidney, had undergone contralateral nephrectomy. The procured kidneys were perfused with iced saline then immediately cold stored in the University of Wisconsin preservation solution. The recipients were randomly allocated to left-to-right or right-to-right groups. Serum creatinine and urine volume were recorded post-transplantation, and the pigs underwent euthanasia at seven days post-transplantation.
All eight pigs showed functioning grafts, immediately producing urine post-transplantation. The serum creatinine level increased the following transplantation gradually and reached a peak on the day of euthanasia. One renal artery thrombosis and one ureterovesical entrance stenosis were observed in the right-to-right group. No complications were observed in the left-to-right group.
We developed and optimized a reproducible porcine kidney transplantation model in the low weight miniature pig. Moreover, we addressed and emphasized critical points of the left-to-right transplantation surgery and detailed the anatomic techniques to avoid stenosis of blood vessels and prevent ureterovesical stricture.
已建立多种猪模型来研究肾脏移植的机制。随着异种移植的发展，对低体重小型猪模型的需求不断增加。然而，尚未充分详细定义一种可靠且可重复的手术技术来建立这些模型并解决可能遇到的障碍。本研究的目的是开发和优化一种低体重小型猪的猪肾移植模型，包括全面的手术描述。
随机选择8只雄性巴马小型猪（12 - 15千克）作为肾脏供体，为便于对移植肾进行研究，对其进行了对侧肾切除术。获取的肾脏用冰盐水灌注，然后立即置于威斯康星大学保存液中冷藏。受体随机分为左到右或右到右组。移植后记录血清肌酐和尿量，并在移植后7天对猪实施安乐死。
所有8只猪的移植肾均发挥功能，移植后立即产生尿液。血清肌酐水平在移植后逐渐升高，并在安乐死当天达到峰值。在右到右组中观察到1例肾动脉血栓形成和1例输尿管膀胱入口狭窄。左到右组未观察到并发症。
我们在低体重小型猪中开发并优化了一种可重复的猪肾移植模型。此外，我们阐述并强调了左到右移植手术的关键点，并详细介绍了避免血管狭窄和预防输尿管膀胱狭窄的解剖技术。
