Renal Transplantation in a Unique Porcine Model: Step-by-Step

Kidney transplantation is the most common solid organ transplantation. The aim of our research is to describe technical and surgical aspects of a porcine model of heterotopic kidney allotransplantation, using up-to-date techniques, utilized nowadays during human kidney transplantation.

We performed a total of 20 heterotopic kidney transplantations on a porcine animal model. The manipulation time, cold ischemia time and surgery time were measured and analyzed over time.

Over the course of the experiment manipulation time decreased by 32% from 28min to 19min, cold ischemia time decreased by 33% from 46min to 31min, and surgery time decreased by 28% from 180min to 130min. All animals had successful reperfusion of the grafts. We witnessed urination of all grafts before performing the ureteral anastomosis. Three grafts had an early graft failure due to an early arterial thrombosis; in the first two cases, the grafts had their artery anastomosed onto a thin external iliac artery, the third thrombosis occurred on a graft with complex arterial anatomy with implanted pole artery.

Our experimental model demonstrated that a pig laboratory model is a useful and valuable tool for surgical training. It can help to shorten the operation times and lower the complication rates. This specific model can also be extended to serve not only as a simple training tool for surgical techniques. Considering pig to human similarities in physiology, biochemistry, and immunology, it can also be used as a short- or long-term model in kidney transplantation.