Outcomes of Two Different Methods of Ureteric Anastomosis in a Mouse Kidney Transplant Model

Abstract

Introduction: The model of kidney transplantation in mice is widely used in transplant immunobiology studies. The surgical procedure is difficult due to problems with the ureteric anastomosis. Two different ureteral reconstructions were used in our mouse kidney transplant model. The outcomes are retrospectively reviewed and compared here. Methods: Method 1. Patch: this involved anastomosis of the donor ureter together with a patch of donor bladder to recipient bladder. Method 2. Implant: this involved using a 5-0 suture to pull the ureter through the bladder wall. The ureter's peripheral tissue was then fixed to the bladder wall at the implant site using 10-0 microsutures. The initial success rate was defined as survival up to the third post-operative day. The donor and recipient times were recorded with a recent subgroup of concurrent transplants. Results: In animals transplanted with the patch method, the initial success rate was 79% (n=62), while initial success rate for the implant method was 86.1% (n=101) (p=0.28). The death rate from unknown and/or unspecified causes in the initial period was 16.1% (10/62) for the patch method, while 8.9% (9/101) for the implant method (p=0.21). The complications of limb paralysis, ureteric stenosis and hydronephrosis were not significant differences with the two methods respectively in terms of initial period (< 3 days), intermediate period (4 to 14 days) and long period (>14 days). Urine leak at the anastomosis site was 10.2% (5/49) with the patch method, while 1.1% (1/87) for the implant method (p=0.02). The average donor/recipient operation time with the implant method was 16±2minutes/64±5minutes (80minutes/transplant) while operation time with the patch method was 29±2minutes/79±2minutes (108minutes/transplant) (p< 0.001). Conclusion: The ureteric implant method for mouse kidney transplantation is a reliable approach with at least as high a success rate as the bladder patch method and with a shorter operation time.