A life-supporting technique of renal allotransplantation in Macaca fascicularis to evaluate novel immunosuppressive drugs in nonhuman primates

被引:21
作者
Borie, DC [1 ]
Hausen, B [1 ]
Larson, MJ [1 ]
Klupp, J [1 ]
Stalder, M [1 ]
Birsan, T [1 ]
Morris, RE [1 ]
机构
[1] Stanford Univ, Sch Med, Dept Cardiothorac Surg, Stanford, CA 94305 USA
关键词
transplantation; kidney transplantation; nonhuman primates; surgery; immunosuppression;
D O I
10.1006/jsre.2002.6499
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background. The use of nonhuman primates in preclinical transplantation studies is becoming more common. This report details complete procedures developed for a successful life-supporting kidney allotransplantation program using the cynomolgus monkey (Macaca fascicularis). Materials and methods. All transplants were performed in wild-caught, ABO-matched, MLR-mismatched adult males. Transplant procedures were staggered: an animal first served as a donor, was allowed to recover for 4 weeks, and was subsequently used as a recipient. The kidney was flushed in situ while the aorta was briefly cross-clamped. The graft was implanted heterotopically end-to-side in the right iliac fossa using microsurgical techniques. An ureteroneocystostomy was constructed; a telemetry probe was inserted into the aorta, and the remaining native kidney was removed. Results. Sixty-two transplants were performed in 6.9 +/- 0.1 kg animals. Operating times in the donor. and recipient were 126 +/- 3 and 166 +/- 5 min, respectively. The cold ischemia time was 55 1 min. There were no intraoperative deaths. Postoperative complications were observed in six (9.7%) monkeys and consisted of one early renal arterial thrombosis and five ureteral complications (two of which were successfully repaired). Transplants were ultimately successful in 93.6% (58/62) of cases. Immediate kidney function was satisfactory, with a mean serum creatinine of 1.7 +/- 0.2 mg/dL and a mean urine output of 140 +/- 15 ml on postoperative day 7. Conclusion. Life-supporting kidney transplantation in cynomolgus macaques is a demanding operation that requires great attention to details. Precise surgical techniques, telemetric monitoring, ultrasound surveillance, and aggressive, early, postoperative fluid resuscitation produced a 94% success rate. (C) 2002 Elsevier Science (USA).
引用
收藏
页码:64 / 74
页数:11
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