ABSTRACT
This study describes an experimental model of accessory renal allotransplantation in the big laboratory animal (pig). A total of 24 common-breed pigs were used. All allografts were transplanted in an accessory manner and revascularized at the level of the infrarenal abdominal aorta and inferior vena cava. The urinary drainage was performed either through a nexternal uretheroneostomy at the ipsilateral lumbar region (Group A--n=8) or by internal uretheroneocystostomy (Group B--n=8). All transplants were monitored for 8 days postoperatively using translumbar ultrasound-guided biopsies at 1, 4, 7 days. A total of 16 transplants were performed. 1 ectopic donor kidney was found and transplanted in the same fashion. Mean operative time was 125 minutes, immediate postoperative survival was 100% and at 72 hours, 87.5%. The onset of acute rejection was at day 4, by massive lymphocyte infiltration and was directly correlated with the abrupt decrease of the allograft diuresis in Group A, at day 3. At day 7, the rejection was complete. Both methods of urinary drainage are functional and can be employed. This experimental model is a useful tool for training of the transplant surgeons or for transplantation research. The surgical technique for accessory renal allotransplantation in pig is easy to learn and offers the possibility for allograft monitoring until complete rejection without influencing the receptor health condition.
Subject(s)
Kidney Transplantation/methods , Urinary Diversion/methods , Animals , Cystostomy , Disease Models, Animal , Drainage , Kidney Diseases/surgery , Sus scrofa , Swine , Transplantation, Homologous , Treatment Outcome , Ureter/surgeryABSTRACT
NOTES (Natural Orifice Translumenal Endoscopic Surgery) represents a very new acquisition in the field of gastrointestinal endoscopy, which uses common flexible endoscopes in order to perform intraperitoneal surgical procedures. This procedure offers a very good visualisation of the peritoneal cavity, as well as the possibility of performing surgical procedures. The aim of the study is to report our experience--the first of its kind in Romania--in performing per os, transgastric procedures, emphasizing the technical challenges and the possible complications associated with this method. This is an experimental study, using pigs (tri-hybrid PIC strain), in which peritoneoscopy and cholecystectomy were performed via a hybrid-NOTES approach (a 5 mm laparoscopic port has been used, placed in the right upper quadrant). The transgastric approach of the peritoneal cavity proved to be easy, allowing simple surgical procedures. The results of the study show the feasibility of the method. During surgery, no serious complications occurred, the minor incidents being managed without conversion to classical or laparoscopic surgery.