Technical Pitfalls to Achieve Long Term Survival in an Heterotopic Small Bowel Transplant Model in Rats.

PABLO STRINGA; NESTOR PEDRAZA; JUAN C. ABATE; GABRIEL E. GONDOLESI ; NATALIA LAUSADA

Simposio; International Small Bowel Transplant Symposium 2015; 2015

Intestinal Transplant Association

Introduction: The rat heterotopic small bowel transplantation (SBT)model is widely used in research work. However, technical complexityand high mortality are the main problems to propagate this technique.We aim to present a detailed video in order to show the keysteps and details to perform a successful procedure.Methods: the video will describe the standard procedure that wasused to perform the last 60 transplants done in our laboratory. All animalswere anesthetized with isoflurane; an analgesic drug, tramadol,was administered immediately before beginning the procedure.Donors were fasted for 12 hours before the surgery. Dissection ofthe entire small intestine in the donor was performed using a bipolarcoagulator in order to shorten the surgical time. The recipient?s operationstarted with the dissection of the infrarenal abdominal aortaand cava vein followed by the engraftment accomplished by an endto-sideanastomosis between the donor?s superior mesenteric arterywith a segment of aortic artery, and recipient?s aortic artery. The sametechnique was used to perform the anastomosis between thedonor?s portal vein and cava vein of maximal width. The graft wasostomized to the right flank. Recipient?s care included 5 cc of salinesc, ceftazidime (60mg/kg IP each 24 hs) and temperature was maintainedwith a blanket until total recovery.Using this technique we were able to perform the procedure with adonor surgical time of 60 minutes. Eighty % survival was obtained at7 days after surgery. The histological evaluation at 30 minutesshowed a post-reperfusion Park index of 2-3, with full recovery at 48hs (Park 0).Conclusion: the use of analgesic drugs, saline to reduce hypovolemicshock, warm care to prevent hypothermia and a short warmischemia time, concomitant with a continuous practice to improveperformance are the main pitfalls that remarkably reduce the complicationrates and improve survival in an heterotopic SBT in rats.