Heterotopic Renal Autotransplantation in a Porcine Model : A Step-by-Step Protocol
Kaths, J. Moritz (Toronto General Hospital. Department of Surgery)
Echeverri Cifuentes, Juan (Universitat Autònoma de Barcelona. Departament de Medicina)
Goldaracena, Nicolas (Toronto General Hospital. Department of Surgery)
Louis, Kristine S. (Toronto General Hospital. Department of Surgery)
Yip, Paul (Toronto General Hospital)
John, Rohan (Toronto General Hospital)
Mucsi, Istvan (Toronto General Hospital. Department of Medicine)
Ghanekar, Anand (Toronto General Hospital. Department of Surgery)
Bagli, Darius (Toronto General Hospital. Department of Surgery)
Selzner, Markus (Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital)
Robinson, Lisa A. (Division of Nephrology, The Hospital for Sick Children)

Data:	2016
Resum:	Kidney transplantation is the treatment of choice for patients suffering from end-stage renal disease. It offers better life expectancy and higher quality of life when compared to dialysis. Although the last few decades have seen major improvements in patient outcomes following kidney transplantation, the increasing shortage of available organs represents a severe problem worldwide. To expand the donor pool, marginal kidney grafts recovered from extended criteria donors (ECD) or donated after circulatory death (DCD) are now accepted for transplantation. To further improve the postoperative outcome of these marginal grafts, research must focus on new therapeutic approaches such as alternative preservation techniques, immunomodulation, gene transfer, and stem cell administration. Experimental studies in animal models are the final step before newly developed techniques can be translated into clinical practice. Porcine kidney transplantation is an excellent model of human transplantation and allows investigation of novel approaches. The major advantage of the porcine model is its anatomical and physiological similarity to the human body, which facilitates the rapid translation of new findings to clinical trials. This article offers a surgical step-by-step protocol for an autotransplantation model and highlights key factors to ensure experimental success. Adequate pre- and postoperative housing, attentive anesthesia, and consistent surgical techniques result in favorable postoperative outcomes. Resection of the contralateral native kidney provides the opportunity to assess post-transplant graft function. The placement of venous and urinary catheters and the use of metabolic cages allow further detailed evaluation. For long-term follow-up studies and investigation of alternative graft preservation techniques, autotransplantation models are superior to allotransplantation models, as they avoid the confounding bias posed by rejection and immunosuppressive medication.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Medicine ; Issue 108 ; Renal ; Kidney ; Organ transplantation ; Porcine ; Pig ; Swine model ; Auto-allotransplantation ; Organ shortage ; Organ preservation technique ; Marginal graft ; Delayed graft function (DGF) ; Primary non-function (PNF)
Publicat a:	Journal of visualized experiments, february 2016, ISSN 1940-087X

DOI: 10.3791/53765
PMID: 26967919

9 p, 1.3 MB

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