Small bowel transplantation in rats using a venous cuff technique

Abstract

A venous cuff technique was applied only for venous drainage in orthotopic small bowel transplantation of rats. Rates of technical failure (death within 4 days) and in clinical signs were compared between the groups with (group A) and without (group B) venous cuff technique. Technical failures with and without venous cuff technique were 5% and 25%, respectively. Mean survival days, excluding deaths from technical failure, were 9.2 +/- 2.3 in group A and 8.1 +/- 2.6 days in group B. No significant differences were observed in mean survival days or in weight loss between the two groups. Acute rejection was the cause of death in both groups. Since the model with venous cuff technique showed low mortality, it could be widely employed in small bowel transplantation studies.

Small bowel transplantation in outbred rats

“…Wallender et al 13 described a model applying the cuff technique to perform end-to-end anastomoses using the recipient's left renal vessels, which is technically easier and faster to learn. However, this technique has the inconvenient of a left nephrectomy and the decreased blood flow provided by the renal artery limits the graft to 40cm of small bowel length 7 .…”

“…Venous-hand suture anastomosis is a rather difficult technique, because the thin-walled vein may be easily torn and overtightening of the running suture can easily occur, resulting in anastomotic stenosis 7 . Systemic drainage is usually preferred, since hand-sewn end-to-side porto-portal anastomosis is considered to be more challenging and is related to a high incidence of venous thrombosis.…”

“…The success rate found in this study was 83.3%, which is comparable to those from literature. are also within the range reported in literature (15 to 25min 7,12 ; 45 to 67min 6,10,11 , 25min 9 and 113 to 120min 9,11 , respectively). Mean donor operation time in this study (40min) is shorter than found in others studies (57 12 , 81 11 and 89min 9 ).…”

Combined cuff and suture technique for orthotopic whole intestinal transplantation in rats

“…2 In addition, microvascular anastomosis in the orthotopic SIT model must be performed quickly but perfectly by an experienced microsurgeon, because rats are intolerant to prolonged total aortic clamping, and the prolonged warm ischemia makes the graft intestine dysfunction. Venous anastomosis is technically more challenging than arterial anastomosis in our experience and that of others, 18 because the thin-walled vein is easily torn, and anastomosis of the graft aorta to the recipient's renal artery. Aorta of the graft anastomoses to the recipient renal artery in an 10 end-to-end fashion (see Fig.…”

“…19 To overcome these problems, we modified a cuff method for venous anastomosis alone, as Kawabe et al showed previously. 18 This significantly decreased the warm ischemic time and prevented bleeding from the venous anastomosis with the suture technique. Additionally, the procedure can be done by researchers without extensive experience with microsurgery.…”