Eur J Pediatr Surg
DOI: 10.1055/s-0038-1632375
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Modified Multivisceral Transplantation with Native Spleen Removal in Rats

Pablo Stringa
Cirugía Experimental, Fundacion Investigacion Biomedica Del Hospital Universitario La Paz, Madrid, Spain
Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMETTYB), Universidad Favaloro-CONICET, Buenos Aires, Argentina
,
Nidia Monserrat Arreola
Hospital de Pediatría, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Mexico
,
Ane M. Andres Moreno
Cirugía Pediátrica, Hospital Universitario La Paz, Madrid, Spain
,
Carlota Largo
Cirugía Experimental, Hospital Universitario La Paz, Madrid, Spain
,
Martín Rumbo
Instituto de Estudios Inmunológicos y Fisiopatológicos (IIFP-CONICET-UNLP), Universidad Nacional de La Plata, La Plata, Buenos Aires, Argentina
,
Francisco Hernandez
Cirugía Experimental, Fundacion Investigacion Biomedica Del Hospital Universitario La Paz, Madrid, Spain
Cirugía Pediátrica, Hospital Universitario La Paz, Madrid, Spain
› Author Affiliations
Further Information

Publication History

05 October 2017

16 January 2018

Publication Date:
23 February 2018 (eFirst)

Abstract

Background Modified multivisceral transplantation (MMVTx) refers to the use of a graft that includes all abdominal organs except the liver. The use of this type of transplant in children and adults expanded over the last years with good results. However, long-term survival in experimental models has not been reported. Our aim is to describe in detail some technical modifications of MMVTx to obtain long-term survival.

Materials and Methods Syngeneic (Lewis–Lewis) heterotopic MMVTx was performed in 16 male rats (180–250 g). All procedures were performed under isoflurane anesthesia. The graft consisted of stomach, duodenopancreatic axis, spleen, and small bowel. The vascular pedicle consisted of a conduit of aorta, including the celiac trunk and the superior mesenteric artery (SMA), and the portal vein (PV). The engraftment was performed by end-to-side anastomosis to the infra-renal cava vein and aorta. After reperfusion, the graft was accommodated in the right side of the abdomen, and a terminal ileostomy performed. The native spleen was removed.

Results Donor and recipient time was 39 ± 4.4 minutes and 69 ± 7 minutes, respectively; venous and arterial anastomosis time was 14 ± 1 minutes and 12.3 ± 1 minutes, respectively. Total ischemia time was 77.2 ± 7.9 minutes. Survival was 75% (12/16), six were sacrificed after 2 hours, and six were kept alive for long-term evaluation (more than 1 week).

Conclusion Long-term survival is reported after heterotopic MMVTx in rats. The heterotopic MMVTx with native spleen removal would potentially improve the existent models for transplant research. The usefulness of this model warrants further confirmation in allogeneic experiments.