Orthotopic Porcine Kidney Transplantation: A Technique to Transplant Graft Kidney in Porcine Model

Abstract

Source: Liu, W. J. et al., Orthotopic Kidney Auto-Transplantation in a Porcine Model Using 24 Hours Organ Preservation and Continuous Telemetry. J. Vis. Exp. (2020).

This video describes orthotopic kidney auto-transplantation in a porcine model. This surgical procedure involves the transplantation of an animal's kidney graft at its original anatomical location. The model is used to investigate new treatments for end-stage kidney diseases in humans.

Protocol

All procedures involving animal models have been reviewed by the local institutional animal care committee and the JoVE veterinary review board. 1. Basic techniques and common procedures Use female German landrace pigs (or comparable) for this protocol. Figure 1 depicts the summary of the described experimental protocol. Deliver the animals to the research facility 14 days before the surgery for acclimatization and house them in a temperature- and humidity-controll…

Representative Results

Figure 1: Study flowchart and protocol. Abbreviations used: POD-postoperative day; ECG-electrocardiography. Figure 2: Animal housing facility with real-time and continuous telemetry monitoring of up to 6 animals. </…

Materials

Anesthesia materials, drugs and medications
Atropine sulfate solution for injection, 100mg	Dr. Franz Köhler Chemie GmbH, Bensheim, Germany	1821288	parasympatholytic agent, premedication
Bepanthen ointment for eyes and nose	Bayer Vital AG, Leverkusen, Germany	1578675	eye ointment
BD Discardit II syringes, 2ml, 5ml, 10ml,20ml	Becton Dickinson GmbH, Heidelberg, Germany	300928, 309050,309110, 300296	syringes
BD Micolance 3 (20G yellow) Cannula	Becton Dickinson GmbH, Heidelberg, Germany	305888	venous catheter
BD Venflon Pro Safety (20G pink)	Becton Dickinson GmbH, Heidelberg, Germany	4491101	venous catheter
Buprenorphine (Buprenovet)	Bayer Vital AG, Leverkusen, Germany	794-996	analgesia
Cefuroxime 750mg, powder for preparing injection solution	FRESENIUS KABI Deutschland GmbH, Bad Homburg, Germany	J01DC02	antibiotics
Covidien Hi-Contour, Endotracheal Tube 7,5 with Cuffed Murphy Eye	Covidien Deutschland GmbH,Neustadt/Donau, Germany	COV-107-75E	endotracheal Tube
FENTANYL 0,5 mg Rotexmedica solution for injection Rotexmedica GmbH	Arzneimittelwerk, Trittau, Germany	4993593	opioide analgetic agent
Furosemide-ratiopharm 250 mg/25 ml solution for injection	Ratiopharm GmbH, Ulm, Germany	1479542	loop diuretics
Glucose 5% solution for infusion (500ml, 250ml)	B. Braun Deutschland GmbH & Co. KG, Melsungen, Germany	3705273, 03705422	infusion fluid
Glucose 20% solution for infusion	B. Braun Deutschland GmbH & Co. KG, Melsungen, Germany	4164483	osmotic diuresis
Heparin-Sodium 5000 I.E./ml	B. Braun Deutschland GmbH & Co. KG, Melsungen, Germany	15782698	anticoagulant
Isoflurane-Piramal (Isoflurane)	Piramal Critical Care Deutschland GmbH, Hallbergmoos, Germany	9714675	volatile anaesthetic agent
Ketamine (Ketamine hydrochloride) 10%	Medistar Arzneimittelvertrieb GmbH, Ascheberg, Germany	4230	general anaestetic agent
MIDAZOLAM 15mg/3ml	Rotexmedica GmbH, Arzneimittelwerk, Trittau, Germany	828093	hypnotica, sedative agent
NaCl 0,9% solution for infusion (500ml,1000ml)	B. Braun Deutschland GmbH & Co. KG, Melsungen, Germany	864671.8779	infusion fluid
Norepinephrine (Arterenol)	Sanofi-Aventis Deutschland GmbH, Frankfurt, Germany	16180	increase in blood pressure
Pantoprazole 40mg/solution for injection	Laboratorios Normon,Madrid, Spain	11068	proton pump inhibitor
Paveron N 25mg/ml solution for injection (Papaverine Hydrochloride)	LINDEN Arzneimittel-Vertrieb-GmbH, Heuchelheim, Germany	2748990	spasmolytic agent for vasodilatation
Propofol 1% (10mg/ml) MCT Fresenius	FRESENIUS KABI Deutschland, GmbH, Bad Homburg, Germany	654210	general anaesthetic agent
Ringer solution	B. Braun Deutschland GmbH & Co. KG, Melsungen, Germany	1471411	infusion fluid
Urine catheter ruffle 12CH	Wirutec Rüsch Medical Vertriebs GmbH, Sulzbach, Germany	RÜSCH-180605-12	transurethral urine catheter
Surgical materials
Appose ULC Skin Stapler	Covidien Deutschland GmbH,Neustadt/Donau, Germany	8886803712	skin stapler
Feather Disposable Scapel (11)(21)	Feather, Japan	8902305.395	scapel
Prolene 2-0, blue monofil VISIBLACK, FS needle	Johnson & Johnson Medical GmbH- Ethicon Deutschland, Norderstedt, Germany	EH7038H	skin
Prolene 5-0 (simply angulated, C1 needle) blue monofil VISI-BLACK	Johnson & Johnson Medical GmbH- Ethicon Deutschland, Norderstedt, Germany	EH7227H	vascular
Prolene 5-0 (double armed, C1 needle) 60cm	Johnson & Johnson Medical GmbH- Ethicon Deutschland, Norderstedt, Germany	KBB5661H	vascular
Prolene 6-0 (double armed, C1 needle) 60cm	Johnson & Johnson Medical GmbH- Ethicon Deutschland, Norderstedt, Germany	EH7228H	vascular
Sempermed derma PF Surgical Gloves Seril Gr. 7, 7.5, 8	Semperit investment Asia Pte Ltd, Singapore	4200782, 4200871, 4200894	surgical gloves
Sentinex® PRO Surgical Gowns Spunlace XL 150cm	Lohmann & Rauscher GmbH & Co. KG, Neuwied, Germany	19302	surgical gown
Telasorp Belly wipes (green 45x45cm)	PAUL HARTMANN AG, Heidenheim, Germany	4542437	abdominal towel
Pediatric urine catheter	Uromed Kurt Drews KG, Oststeinbeck, Germany	PZN 03280856	used for the uretero-cutaneus stoma
VICRYL- 0 MH Plus	Johnson & Johnson Medical GmbH- Ethicon Deutschland, Norderstedt, Germany	V324	fascial closure
VICRYL – 3-0, SH1 Plus needle, 75cm	Johnson & Johnson Medical GmbH- Ethicon Deutschland, Norderstedt, Germany	W9114	subcutaneous suture, peritoneal suture
VICRYL – 3-0, SH1 Plus needle, 75cm	Johnson & Johnson Medical GmbH- Ethicon Deutschland, Norderstedt, Germany	V780	subcutaneous suture, peritoneal suture
VICRYL – ligatures Sutupak purple braided, 3-0	Johnson & Johnson Medical GmbH- Ethicon Deutschland, Norderstedt, Germany	V1215E	threads for ligature
3M™ Standard Surgical Mask 1810F	3M Deutschland GmbH, Neuss, Germany	3M-ID 7000039767	surgical mask
Surgical instruments
Anatomical forceps Standard	ASANUS Medizintechnik GmbH, Tuttlingen, Germany	PZ0260	anatomical forceps
Atraumatic tweezers steel, De Bakey Tip 1,5mm 8"	ASANUS Medizintechnik GmbH, Tuttlingen, Germany	GF0840	anatomical atraumatic forceps
Bipolar forceps 16 cm straight, Branch 0,30 mm pointed, universal fit	Bühler Instrumente Medizintechnik GmbH,Tuttlingen, Germany	08/0016-A	biopolar forceps
Bulldog clamp atraumatic, curved, De bakey 78 mm, 3"	ASANUS Medizintechnik GmbH, Tuttlingen, Germany	GF0900	bulldog clamps
DE BAKEY-SATINSKY vascular clamp 215mm	ASANUS Medizintechnik GmbH, Tuttlingen, Germany	GF1661	vascular clamp
Dissecting scissors Mayo, 250 mm, 10"	ASANUS Medizintechnik GmbH, Tuttlingen, Germany	SC2232	Scissors for dissection
Dissecting scissors Metzenbaum-Fino, 260 mm, 101/4"	ASANUS Medizintechnik GmbH, Tuttlingen, Germany	SC2290	Scissors for dissection
Draeger CATO Anesthetic machine with PM8050 Monitor	Dräger, Drägerwerk AG & Co. KGaA, Lübeck, Germany	106782	Ventilation System
Fine Tweezers, ADSON 180 mm	ASANUS Medizintechnik GmbH, Tuttlingen, Germany	ADSONPZ0571	fine forceps
Gosset abdomenal wall spreader	CHIRU-INSTRUMENTE, Kaierstuhl, Germany	09-621512	abdominal retractor
Microsurgical/watermaker tweezers LINZ 150mm 6" Ergo round handle	ASANUS Medizintechnik GmbH, Tuttlingen, Germany	MN0087	fine microsurgical forceps
Surgical forceps Standard 5 3/4"	ASANUS Medizintechnik GmbH, Tuttlingen, Germany	PZ1260	surgical forceps
Surgical scissors standard pointed-blunt (thread/cloth scissors)175 mm, 7"	ASANUS Medizintechnik GmbH, Tuttlingen, Germany	SC1522	surgical scissors
Further material
Heating pad	Eickemeyer – Medizintechnik für Tierärzte KG, Tuttlingen, Germany	648050 MHP-E1220	maintain body temperature during surgery
Laryngoscope, customized	Wittex GmbH, Simbach, Germany	333222230	expose the vocal cord
Rectal temperature probe	Asmuth Medizintechnik, Minden, Germany	ASD-RA4	measure body temperature
Ultrasound device, Sonosite Edge-II	FUJIFILM SonoSite GmbH, Frankfurt, Germany	V21822	ultrasound and color Doppler
Urine bag 2000ml Volume	ASID BONZ GmbH, Herrenberg, Germany	2062578	disposable urine bag connected to the uretero-cutaneous fistula catheter