Heterotopic renal autotransplantation in a porcine model: A step-by-step protocol

J. Moritz Kaths, Juan Echeverri, Nicolas Goldaracena, Kristine S. Louis, Paul Yip, Rohan John, Istvan Mucsi, Anand Ghanekar, Darius Bagli, Markus Selzner, Lisa A. Robinson

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Abstract

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.

Original languageEnglish
Article numbere53765
JournalJournal of Visualized Experiments
Volume2016
Issue number108
DOIs
Publication statusPublished - Feb 21 2016

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Keywords

  • Auto-allotransplantation
  • Delayed graft function (DGF)
  • Issue 108
  • Kidney
  • Marginal graft
  • Medicine
  • Organ preservation technique
  • Organ shortage
  • Organ transplantation
  • Pig
  • Porcine
  • Primary non-function (PNF)
  • Renal
  • Swine model

ASJC Scopus subject areas

  • Neuroscience(all)
  • Chemical Engineering(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)

Cite this

Kaths, J. M., Echeverri, J., Goldaracena, N., Louis, K. S., Yip, P., John, R., Mucsi, I., Ghanekar, A., Bagli, D., Selzner, M., & Robinson, L. A. (2016). Heterotopic renal autotransplantation in a porcine model: A step-by-step protocol. Journal of Visualized Experiments, 2016(108), [e53765]. https://doi.org/10.3791/53765