Kidney transplantation in the rat: A modified technique using hydrodissection

Abstract

Here, hydrodissection was compared with the conventional blunt instrumental dissection approach in a rat model of orthotopic kidney transplantation. Forty male Fisher and Lewis rats were used as kidney donors and recipients, respectively. After recipient nephrectomy, left kidney grafts were implanted orthotopically using standard microsurgical techniques. Two different methods of dissection of the graft and recipient vessels were used. In method A, the dissection was performed using blunt dissection with cotton-tipped sticks and jeweler's forceps (n = 20), and in method B, dissection was performed using water dissection technique (n = 20). Hydrodissection displayed the correct plane of dissection, reduced the operating time, and reduced the overall complication (P < 0.001) and vasospasm (P < 0.05) rates. This is the first report of the use of hydrodissection in experimental transplantation. This atraumatic dissection technique does not require any special instruments, is fast, safe, demands less surgical skills, and may be useful in other transplantation models.

Surgical Anatomy and Microvascular Surgical Technique Relevant to Experimental Renal Transplant in Rat Employing Aortic and Inferior Venacaval Conduits

“…Dissection of the retroperitoneum was performed using sharp and blunt dissections with 2 microdissection forceps and baby swab sticks. 8 Figure 1b and 1c and Figure 2 show detailed anatomy of the arterial and venous systems related to donor nephrectomy and recipient RT. The left renal artery invariably has adrenal and ureteric branches, where the former requires ligation before division to prevent bleeding and the latter required preservation to maintain the blood supply to the ureter.…”

Rapid harvesting both kidneys from one donor rat for transplantation with a technique of sharp dissection after irrigation

“…It has been reported 7 that conventional blunt dissection is associated with a high rate of complications (vein stenosis, injuries, arterial thromboses, and spasm). Martins et al 7 used a combination of hydrodissection and sharp dissection for renal transplantation in rats. The sharp dissection technique is fast, avoids blood vessel injuries and spasms, but needs a clear operating field of view and clearly identifiable dissection planes between different tissues.…”

“…13 Later, most investigators favored left donor nephrectomy because it was easier to gain access to the operating field without the need to retract the liver or deal with the SMA. 7,9,[14][15][16][17] In our study, six of 20 donor rats had SMAs that originated from the AO between the RRA and LRA and five had SMAs that originated from the AO in the plane of the RRA. The stumps of these SMAs had to be ligated and preserved in order to use the right donor kidneys.…”

“…The occurrence of vasospasm was defined as full perfusion flow through the graft after an initial period <10 minutes of slow reperfusion as described elsewhere. 7 The long-term survival of the graft was evaluated by histological study with hematoxylin and eosin staining.…”

“…6 In addition, it has been reported that the conventional blunt dissection techniques may cause vascular injuries, thromboses, and renal arterial vasospasms during the donor kidney harvesting. 1,4,7,8 In this study, we attempted to develop a procedure of harvesting both kidneys from one donor rat for transplantation with reversing the sequence of vascular dissection and irrigation of the grafts and using the sharp dissection technique. The operation time and complication rates of this technique were compared to the conventional technique.…”