Yoshitaka Kinoshita1, Daiki Iwami2, Tetsuya Fujimura3, Haruki Kume4, Takashi Yokoo5, Eiji Kobayashi6. 1. MD. Jichi Medical University - Department of Urology - Division of Renal Surgery and Transplantation - Tochigi, Japan. Jichi Medical University - Department of Urology - Division of Urology - Tochigi, Japan. 2. MD, PhD. Jichi Medical University - Department of Urology - Division of Renal Surgery and Transplantation - Tochigi, Japan. 3. .MD, PhD. Jichi Medical University - Department of Urology - Division of Urology - Tochigi, Japan. 4. MD, PhD. The University of Tokyo - Graduate School of Medicine - Department of Urology - Tokyo, Japan. 5. MD, PhD. The Jikei University School of Medicine - Department of Internal Medicine - Division of Nephrology and Hypertension - Tokyo, Japan. 6. MD, PhD. The Jikei University School of Medicine - Department of Kidney Regenerative Medicine; Keio University School of Medicine - Department of Organ Fabrication - Tokyo, Japan.
Abstract
PURPOSE: Although transplanting two kidneys from a single donor to two recipients has some advantages, the right and left kidneys are not anatomically identical; thus, a surgical procedure considering the anatomical features of the donor kidneys is needed when transplanting them into the opposite renal fossae. Based on vast experience, the surgical details of pig orthotopic kidney transplantation from one donor to two recipients was reported. METHODS: When the right kidney was transplanted to the left renal fossa, the graft was inverted upside down, not backwards, thus ensuring that the anteroposterior relationship of the renal vessels was maintained and anatomically natural vascular anastomosis could be performed. RESULTS: Using this technique, we could have developed a pig experimental model that is safe and has a high success rate, even for researchers in the middle of their training. This technique of inverting the graft upside down was reported in human kidney transplantation to make vascular anastomosis easier. CONCLUSIONS: In pig orthotopic kidney transplantation from one donor to two recipients, an anatomically natural vascular anastomosis could be performed via inverted grafting when the right kidney was transplanted into the left renal fossa.
PURPOSE: Although transplanting two kidneys from a single donor to two recipients has some advantages, the right and left kidneys are not anatomically identical; thus, a surgical procedure considering the anatomical features of the donor kidneys is needed when transplanting them into the opposite renal fossae. Based on vast experience, the surgical details of pig orthotopic kidney transplantation from one donor to two recipients was reported. METHODS: When the right kidney was transplanted to the left renal fossa, the graft was inverted upside down, not backwards, thus ensuring that the anteroposterior relationship of the renal vessels was maintained and anatomically natural vascular anastomosis could be performed. RESULTS: Using this technique, we could have developed a pig experimental model that is safe and has a high success rate, even for researchers in the middle of their training. This technique of inverting the graft upside down was reported in human kidney transplantation to make vascular anastomosis easier. CONCLUSIONS: In pig orthotopic kidney transplantation from one donor to two recipients, an anatomically natural vascular anastomosis could be performed via inverted grafting when the right kidney was transplanted into the left renal fossa.