Renal Transplantation by Automatic Anastomotic Device in a Porcine Model

Abstract

Automatic vascular staplers for vascular anastomoses in kidney transplantation may dramatically reduce the operative time and, in particular, warm ischemia time, thus increasing the outcome of transplantation. Ten pigs underwent kidney auto-transplantation by automatic anastomotic device. Kidneys were collected by laparotomy with selective ligations at the renal hilum and perfused with cold storage solution. To overcome the shortage in length of renal hilum, a tract of the internal jugular vein was harvested to increase the length of the vessels. The anastomoses were totally performed by the use of the anastomotic device. On 10 kidney transplants, nine were successful and no complications occurred. Renal resistive indexes showed a slight increase in the immediate postoperative period returning normal at 10 days of follow-up. We demonstrated the possibility to perform renal vascular anastomoses by means of an automatic anastomotic device. This instrument developed for coronary bypass surgery by virtue of the small caliber of the vessels could be adopted on a larger scale for renal transplantation. The reduced warm ischemia time needed for anastomosis may help to achieve a better outcome for the graft and expand the pool of marginal donors in renal transplantation.

Working towards an ERAS Protocol for Pancreatic Transplantation: A Narrative Review

“…The use of automated staplers for duodenal work may also help to reduce operative time and should be pursued as part of the ERAS pathway. Porcine studies in renal transplantation have demonstrated the use of an automatic vascular anastomotic device, initially designed for coronary artery bypass grafting, can reduce warm ischemic time and may play a beneficial role in pancreas transplantation [88]. Finally, robotic pancreas transplantation is being developed for highrisk obese patients at higher risk of postoperative complications [89][90][91][92].…”

Fascinating Dendritic Cells—Sentinel Cells of the Immune System a Review

“…The human and the porcine IS have many similarities with regard to DC biology [3]. The porcine model has found application in many biomedical industries such as wound healing (skin) models [51], renal anatomy models [32], or cardiac cell therapy [59], thus, there is a growing interest in porcine immunology due to the potential of the pigs as a donor in xenotransplantation [12,23,35,49]. Currently, the two most common protocols are used to generate DC from peripheral blood monocytes [39].…”

Artificial Organs 2015: A Year in Review

“…Attilio Ignazio Lo Monte et al of the University of Palermo, Palermo, Italy reported on renal transplantation by automatic anastomotic device in a porcine model. Of 10 kidney transplants, nine were successful and no complications occurred.…”