The mouse small bowel transplantation model has been recognized as an important tool to study mechanismes of immune rejection and screen new immunosuppressive drugs. However, this model is limited to use because the techniques involved is an extremely technically challenge. Now we introduce the modified technique.
Abstract
Since 1990, the development of tacrolimus-based immunosuppression and improved surgical techniques, the increased array of potent immunosuppressive medications, infection prophylaxis, and suitable patient selection helped improve actuarial graft and patient survival rates for all types of intestine transplantation. Patients with irreversible intestinal failure and complications of parenteral nutrition should now be routinely considered for small intestine transplantation. However, Survival rates for small intestinal transplantation have been slow to improve compares increasingly favorably with renal, liver, heart and lung. The small bowel transplantation is still unsatisfactory compared with other organs. Further progress may depend on better understanding of immunology and physiology of the graft and can be greatly facilitated by animal models. A wider use of mouse small bowel transplantation model is needed in the study of immunology and physiology of the transplantation gut as well as efficient methods in diagnosing early rejection. However, this model is limited to use because the techniques involved is an extremely technically challenging. We have developed a modified technique. When making anastomosis of portal vein and inferior vena cava, two stay sutures are made at the proximal apex and distal apex of the recipient s inferior vena cava with the donor s portal vein. The left wall of the inferior vena cava and donor s portal vein is closed with continuing sutures in the inside of the inferior vena cava after, after one knot with the proximal apex stay suture the right wall of the inferior vena cava and the donor s portal vein are closed with continuing sutures outside the inferior vena cave with 10-0 sutures. This method is easier to perform because anastomosis is made just on the one side of the inferior vena cava and 10-0 sutures is the right size to avoid bleeding and thrombosis. In this article, we provide details of the technique to supplement the video.
Protocol
Donor preparation and small bowel harvest: The mouse is ansetheized with an intraperitoneal injection of pentobarbital and placed supine on the operation field. A long midline abdominal incision is made. The proximal of jejunum is identified and ligated with 6-0 sutures. Attached mesenteric vessels distal to the jejunum tie are ligated with 8-0 sutures. The distal of ileum is identified and ligated with 6-0 sutures. The attached mesenteric vessels distal to the ileum are ligated with 8-0 sutu…
Discussion
The unique immune response after small bowel transplantation has been the subject of extensive research using small bowel transplantation model in mice. The basic immunological reactions, such as graft-versus-reactions, host-versus-graft-reaction, a combination of both reactions, chronic rejection and tolerance have been involved. Almost all immunosuppressive agents of proven or potential clinical relevance have been tested for their efficacy in small bowel transplantation model.