Li Jinsheng, Yu Yifan, Dong Lingjun, Lou Zhiling, Fang Qiuyu, Liang Fuxiang, Li Yangfan, Wu Ming
Department of Thoracic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China.
Heliyon. 2024 May 9;10(10):e30728. doi: 10.1016/j.heliyon.2024.e30728. eCollection 2024 May 30.
To enhance the operability of the rat orthotopic left lung transplantation model, we implemented several improvements and meticulously detailed the procedure. One hundred and thirty-one healthy male Sprague Dawley rats, weighing between 250 and 300 g, were utilized, with 64 serving as donors, 64 as recipients, and 3 as sham controls. We employed a modified three-cuff technique for the orthotopic left lung transplantation. Notably, our modified perfusion method could prevent donor lung edema, while waist-shaped cuffs minimized suture slippage during anastomosis. Additionally, positioning the recipient rat in a slightly left-elevated supine position during anastomosis reduced tension on the lung hilum, thus mitigating the risk of vascular laceration. The introduction of a unique two-person anastomosis technique significantly reduced operation time and substantially improved success rates. Furthermore, maximizing inflation of donor lungs both during preservation and surgery minimized the occurrence of postoperative atelectasis. Various other procedural refinements contributed to the enhanced operability of our model. Sixty-four rat orthotopic left lung transplantations were performed with only one surgical failure observed. The acquisition time for donor lungs averaged (19 ± 4) minutes, while (11 ± 1) minutes were allocated for donor lung hilum anatomy and cuff installation. Recipient thoracotomy and left lung hilar anatomy before anastomosis required (24 ± 8) minutes, with anastomosis itself taking (31 ± 6) minutes. Remarkably, the survival rate at the 4-h postoperative mark stood at 96.7 %. Even six months post-operation, transplanted left rat lungs continued to exhibit proper inflation and contraction rhythms, displaying signs of chronic pathological changes. In summary, our modified rat model of orthotopic left lung transplantation demonstrates robust operability, significantly reducing surgical duration, improving operation success rates, and enhancing postoperative survival rates. Furthermore, its long-term survival capacity enables the simulation of acute and chronic disease processes following lung transplantation.
为提高大鼠原位左肺移植模型的可操作性，我们进行了多项改进并详细阐述了操作过程。使用了131只体重在250至300克之间的健康雄性Sprague Dawley大鼠，其中64只作为供体，64只作为受体，3只作为假手术对照。我们采用改良的三袖套技术进行原位左肺移植。值得注意的是，我们改良的灌注方法可防止供体肺水肿，而腰形袖套可最大程度减少吻合过程中的缝线滑脱。此外，在吻合过程中将受体大鼠置于略向左抬高的仰卧位可减轻肺门处的张力，从而降低血管撕裂的风险。引入独特的双人吻合技术显著缩短了手术时间并大幅提高了成功率。此外，在保存和手术过程中使供体肺充分膨胀可最大程度减少术后肺不张的发生。其他各种操作改进也有助于提高我们模型的可操作性。共进行了64例大鼠原位左肺移植，仅观察到1例手术失败。供体肺获取时间平均为(19±4)分钟，而供体肺门解剖和袖套安装时间为(11±1)分钟。吻合前受体开胸和左肺门解剖需要(24±8)分钟，吻合本身需要(31±6)分钟。值得注意的是，术后4小时的存活率为96.7%。甚至在术后六个月，移植的大鼠左肺仍继续表现出正常的膨胀和收缩节律，显示出慢性病理变化的迹象。总之，我们改良的大鼠原位左肺移植模型具有强大的可操作性，显著缩短了手术时间，提高了手术成功率，并提高了术后存活率。此外，其长期存活能力能够模拟肺移植后的急性和慢性疾病过程。
