Department of Kidney Transplantation, Second Xiangya Hospital, Central South University, Changsha 410011.
Clinical Research Center for Organ Transplantation in Hunan Province, Changsha 410011.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2024 Feb 28;49(2):220-235. doi: 10.11817/j.issn.1672-7347.2024.230599.
The mouse kidney transplantation model presents challenges in terms of surgical difficulty and low success rate, making it difficult to master. This study aims to provide a crucial model for transplantation immunology research by modifying and developing novel techniques for mouse kidney transplantation.
A total of 57 pairs of mice were used to establish and compare the modified and innovative surgical techniques for mouse kidney transplantation. Three different surgical models were established, including the abdominal suture technique for orthotopic kidney transplantation, the abdominal cuff technique for orthotopic kidney transplantation, and the cervical cuff technique for ectopic kidney transplantation. BALB/c or C57BL/6 male mice, aged 8 to 12 weeks and weighed 20 to 25 g with specified pathogen free-grade were served as the donor mice or the recipient mice. The surgical technique characteristics, key surgical times, complications, and pathological examination in the early postoperative period were summarized and compared.
Three different surgical models of mouse kidney transplantation were successfully established. The comparison of warm ischemic time for the 3 groups of mice showed no statistical significance (=0.510 4). The abdominal suture group had the shortest total operation time of the donor compared with the abdominal cuff group and the cervical cuff group [(18.3±3.6) min vs (26.2±4.7) min and (22.8±2.5) min; both <0.000 1]. There was a significant difference in cold ischemia time among the 3 groups (all <0.000 1), with (60.8±4.1) min in the cervical cuff group, (43.3±5.0) min in the abdominal suture group, and (88.8±6.7) min in the abdominal cuff group. Due to different anastomosis methods, the cervical cuff group had the shortest time [(17.6±2.7) min], whereas the abdominal cuff group had the longest time [(38.8±5.4) min]. The total operation time for the recipients showed significant differences (<0.000 1), with the abdominal suture group having the shortest time [(44.0±6.9) min], followed by the cervical cuff group [(64.1±5.2) min], and the abdominal cuff group [(80.0±6.0) min] being the longest. In the 32 mice of the abdominal suture group, there were 6 with intraoperative bleeding, including 1 arterial intimal injury bleeding and 5 with bleeding after vessel opening. Six mice had ureteral complications, including ureteral bladder anastomotic stenosis, necrosis, and renal pelvis dilation. Two mice had postoperative abdominal infections. In the abdominal cuff group, there was no intraoperative bleeding, but 6 mice showed mild arterial stenosis and 5 showed venous stenosis, 4 arterial injury, 4 arterial thrombosis, and 2 ureteral complications. No postoperative infections occurred in the mice. In the cervical cuff group, no intraoperative bleeding, arterial intimal injury, arterial/venous stenosis, or thrombosis were found in 13 mice. Five mice had ureteral complications, including ureteral necrosis and infection, which were the main complications in the cervical cuff group. The renal function in mice of the 3 groups remained stable 7 days after surgery. Hematoxylin and eosin staining and periodic acid-Schiff staining showed no significant differences in terms of acute rejection among the 3 surgical methods (all >0.05).
All 3 surgical methods are able to successfully establish mouse kidney transplantation models, with no significant differences observed in the short-term graft survival and acute rejection. The modified abdominal suture technique and abdominal cuff technique have their respective advantages in research applications. The novel cervical cuff technique for ectopic kidney transplantation model is relatively simple to be prepared and causes less trauma to the mice, providing more options for studies involving xenotransplantation, secondary transplantation, and local lymphatic drainage. However, the difficulty in harvesting the donor kidney and the high incidence of ureteral infections need further validation in long-term survival. This study holds important reference value for choosing the type of mouse kidney transplantation model for different research needs.
小鼠肾脏移植模型在手术难度和成功率方面存在挑战,难以掌握。本研究旨在通过改进和开发新的小鼠肾脏移植技术,为移植免疫学研究提供关键模型。
共使用 57 对小鼠建立并比较了改良和创新的小鼠肾脏移植手术技术。建立了三种不同的手术模型,包括原位肾脏移植的腹部缝合技术、原位肾脏移植的腹部套管技术和异位肾脏移植的颈部套管技术。BALB/c 或 C57BL/6 雄性小鼠,年龄 8 至 12 周,体重 20 至 25g,无特定病原体级,作为供体小鼠或受体小鼠。总结并比较了手术技术特点、关键手术时间、并发症和术后早期的病理检查。
成功建立了三种不同的小鼠肾脏移植手术模型。三组小鼠的热缺血时间比较无统计学意义(=0.5104)。与腹部套管组和颈部套管组相比,供体组的腹部缝合组总手术时间最短[(18.3±3.6)min 比(26.2±4.7)min 和(22.8±2.5)min;均<0.0001]。三组的冷缺血时间差异有统计学意义(均<0.0001),颈部套管组为(60.8±4.1)min,腹部缝合组为(43.3±5.0)min,腹部套管组为(88.8±6.7)min。由于吻合方法不同,颈部套管组时间最短[(17.6±2.7)min],而腹部套管组时间最长[(38.8±5.4)min]。受体的总手术时间差异有统计学意义(<0.0001),腹部缝合组最短[(44.0±6.9)min],其次是颈部套管组[(64.1±5.2)min],腹部套管组最长[(80.0±6.0)min]。在腹部缝合组的 32 只小鼠中,有 6 只术中出血,包括 1 只动脉内膜损伤出血和 5 只血管开放后出血。6 只小鼠出现输尿管并发症,包括输尿管膀胱吻合口狭窄、坏死和肾盂扩张。2 只小鼠术后腹部感染。腹部套管组术中无出血,但 6 只小鼠轻度动脉狭窄和 5 只静脉狭窄,4 只动脉损伤,4 只动脉血栓形成和 2 只输尿管并发症。小鼠无术后感染。在颈部套管组的 13 只小鼠中,未发现术中出血、动脉内膜损伤、动脉/静脉狭窄或血栓形成。5 只小鼠出现输尿管并发症,包括输尿管坏死和感染,这是颈部套管组的主要并发症。术后 7 天,三组小鼠肾功能均稳定。苏木精和伊红染色和过碘酸希夫染色显示三种手术方法的急性排斥反应无明显差异(均>0.05)。
三种手术方法均能成功建立小鼠肾脏移植模型,短期移植物存活率和急性排斥反应无显著差异。改良的腹部缝合技术和腹部套管技术在研究应用中各有优势。新型异位肾脏移植模型的颈部套管技术相对简单,对小鼠的创伤较小,为异种移植、二次移植和局部淋巴引流研究提供了更多选择。然而,供体肾脏的获取难度和输尿管感染的高发生率需要在长期存活方面进一步验证。本研究对选择不同研究需求的小鼠肾脏移植模型类型具有重要参考价值。