A Modified Surgical Technique for Kidney Transplantation in Mice

Decheng Yin; Jian Fu; Rongjun Chen; Nelli Shushakova; Ida Allabauer; Xin-Yi Wei; Mario Schiffer; Diana Dudziak; Song Rong; André Hoerning

doi:10.3791/63434

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Method Article

A Modified Surgical Technique for Kidney Transplantation in Mice

6.8K views

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DOI:

10.3791/63434

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July 22nd, 2022

Decheng Yin^*¹^,² , Jian Fu^*¹^,³ , Rongjun Chen⁴ , Nelli Shushakova⁵ , Ida Allabauer¹ , Xin-Yi Wei¹ , Mario Schiffer⁶ , Diana Dudziak⁷ , Song Rong^*⁵ , André Hoerning^*¹

¹Department of Pediatric and Adolescent Medicine, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, ²Department of Pediatric Surgery, Chengdu Women’s and Children's Central Hospital, ³The Key Laboratory of Hainan Trauma and Disaster Rescue, The first affiliated Hospital of Hainan Medical University, ⁴Department of Department of Pediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, ⁵Department of Nephrology, Hannover Medical School, ⁶Department of Nephrology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, ⁷Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg

^* These authors contributed equally

Summary

This protocol presents a new surgical technique of mouse kidney transplantation focusing on a modified arterial anastomosis strategy. A vascular suture technique including a simple and safer ureter-bladder anastomosis method is also presented. These modifications shorten the operation time and improve the success rate of the mouse kidney transplantation procedure.

Abstract

Kidney transplantation in mice is a complicated and challenging surgery procedure. There are very few publications demonstrating the key steps of this operation. Therefore, this article introduces the technique and points out the surgical caveats associated with this operation. In addition, important modifications in comparison to the conventional procedure are demonstrated. Firstly, a patch of the abdominal aorta is cut and prepared so that the proximal bifurcations of the renal artery, including the ureteral artery are transected together with the donor kidney en bloc. This reduces the risk of a ureter necrosis and avoids the development of a urinary tract occlusion. Secondly, a new method of the vascular anastomosis is demonstrated that allows the operator to flexibly increase or decrease the size of the anastomosis after renal transplant reperfusion has already been initiated. This avoids the development of vessel strictures and intraabdominal bleeding. Thirdly, a technique that enables the anastomosis of the delicate donor ureter and the recipient bladder that does not cause a trauma is shown. Adopting this protocol can shorten the operation time and reduces the damage to the recipient's bladder, thereby significantly increasing the operation success rate for the recipient mice.

Introduction

Since Sakowitz et al. developed mouse models of kidney transplantation in 1973 for the first time¹, it has proven as an important experimental tool to study the mechanisms of transplant ischemic injury and alloimmune rejection as well as for developing new treatments aimed to prolong allograft survival and possibly to achieve immunological tolerance. However, the surgical technique has proven to be complex and very demanding, sometimes having complications such as vascular anastomotic strictures leading to prerenal non-immunological kidney transplant failure², postrenal failure caused by ischemia and subsequent necrosis ....