Volume 15 Issue 2
Mar.  2024
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Xu Yong, Song Xiangyu, Wang Heng’en, et al. Research report of living donor kidney harvesting in Bama miniature pigs with six gene modified[J]. ORGAN TRANSPLANTATION, 2024, 15(2): 229-235. doi: 10.3969/j.issn.1674-7445.2023215
Citation: Xu Yong, Song Xiangyu, Wang Heng’en, et al. Research report of living donor kidney harvesting in Bama miniature pigs with six gene modified[J]. ORGAN TRANSPLANTATION, 2024, 15(2): 229-235. doi: 10.3969/j.issn.1674-7445.2023215

Research report of living donor kidney harvesting in Bama miniature pigs with six gene modified

doi: 10.3969/j.issn.1674-7445.2023215
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  • Corresponding author: Sun Shengkun , Email:sunshengkun@301hospital.com.cn
  • Received Date: 2023-10-14
  • Accepted Date: 2023-12-06
  • Available Online: 2024-01-17
  • Publish Date: 2024-03-15
  •   Objective  To summarize the experience and practical value of living donor kidney harvesting in Bama miniature pigs with six gene modified.   Methods  The left kidney of Bama miniature pigs with six gene modified was obtained by living donor kidney harvesting technique. First, the ureter was occluded, and then the inferior vena cava and abdominal aorta were freed. During the harvesting process, the ureter, renal vein and renal artery were exposed and freed in sequence. The vascular forceps were used at the abdominal aorta and inferior vena cava, and the renal artery and vein were immediately perfused with 4℃ renal preservation solution, and stored in ice normal saline for subsequent transplantation. Simultaneously, the donor abdominal aorta and inferior vena cava gap were sutured. The operation time, blood loss, warm and cold ischemia time, postoperative complications and the survival of donors and recipients were recorded.   Results  The left kidney of the genetically modified pig was successfully harvested. Intraoperative bleeding was 5 mL, warm ischemia time was 45 s, and cold ischemia time was 2.5 h. Neither donor nor recipient pig received blood transfusion, and urinary function of the kidney transplanted into the recipient was recovered. The donor survived for more than 8 months after the left kidney was resected.   Conclusions  Living donor kidney harvesting is safe and reliable in genetically modified pigs. Branch blood vessels could be processed during kidney harvesting, which shortens the process of kidney repair and the time of cold ischemia. Living donor kidney harvesting contributes to subsequent survival of donors and other scientific researches.

     

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  • [1]
    SYKES M, SACHS DH. Transplanting organs from pigs to humans[J]. Sci Immunol, 2019, 4(41): eaau6298. DOI: 10.1126/sciimmunol.aau6298.
    [2]
    YAMADA K, ARIYOSHI Y, POMPOSELLI T, et al. Co-transplantation of vascularized thymic graft with kidney in pig-to-nonhuman primates for the induction of tolerance across xenogeneic barriers[J]. Methods Mol Biol, 2020, 2110: 151-171. DOI: 10.1007/978-1-0716-0255-3_11.
    [3]
    赵恒, 徐凯祥, 范柠粼, 等. 基因编辑异种移植供体猪的构建及现状[J/CD]. 实用器官移植电子杂志, 2018, 6(5): 412-418. DOI: 10.3969/j.issn.2095-5332.2018.05.018.

    ZHAO H, XU KX, FAN NL, et al. Construction and current status of genetically edited xenograft donor pigs [J/CD]. Pract J Organ Transplant(Electr Vers), 2018, 6(5): 412-418. DOI: 10.3969/j.issn.2095-5332.2018.05.018.
    [4]
    VERNOOIJ RWM, LAW W, PETERS SAE, et al. The probability of receiving a kidney transplantation in end-stage kidney disease patients who are treated with haemodiafiltration or haemodialysis: a pooled individual participant data from four randomised controlled trials[J]. BMC Nephrol, 2021, 22(1): 70. DOI: 10.1186/s12882-021-02265-6.
    [5]
    BURGAN CM, SUMMERLIN D, LOCKHART ME. Renal transplantation: pretransplant workup, surgical techniques, and surgical anatomy[J]. Radiol Clin North Am, 2023, 61(5): 797-808. DOI: 10.1016/j.rcl.2023.04.003.
    [6]
    WANG Y, LEI T, WEI L, et al. Xenotransplantation in China: present status[J]. Xenotransplantation, 2019, 26(1): e12490. DOI: 10.1111/xen.12490.
    [7]
    COZZI E, SCHNEEBERGER S, BELLINI MI, et al. Organ transplants of the future: planning for innovations including xenotransplantation[J]. Transpl Int, 2021, 34(11): 2006-2018. DOI: 10.1111/tri.14031.
    [8]
    COOPER DKC, HARA H, IWASE H, et al. Pig kidney xenotransplantation: progress toward clinical trials[J]. Clin Transplant, 2021, 35(1): e14139. DOI: 10.1111/ctr.14139.
    [9]
    RODGER D, HURST DJ, COOPER DK. Xenotransplantation: a historical-ethical account of viewpoints[J]. Xenotransplantation, 2023, 30(2): e12797. DOI: 10.1111/xen.12797.
    [10]
    SYKES M, SACHS DH. Progress in xenotransplantation: overcoming immune barriers[J]. Nat Rev Nephrol, 2022, 18(12): 745-761. DOI: 10.1038/s41581-022-00624-6.
    [11]
    ARABI TZ, SABBAH BN, LERMAN A, et al. Xenotransplantation: current challenges and emerging solutions[J]. Cell Transplant, 2023, 32: 9636897221148771. DOI: 10.1177/09636897221148771.
    [12]
    ANAND RP, LAYER JV, HEJA D, et al. Design and testing of a humanized porcine donor for xenotransplantation[J]. Nature, 2023, 622(7982): 393-401. DOI: 10.1038/s41586-023-06594-4.
    [13]
    SINGH AK, CHAN JL, SEAVEY CN, et al. CD4+CD25Hi FoxP3+ regulatory T cells in long-term cardiac xenotransplantation[J]. Xenotransplantation, 2018, 25(2): e12379. DOI: 10.1111/xen.12379.
    [14]
    HAWTHORNE WJ. World first pig-to-human cardiac xenotransplantation[J]. Xenotransplantation, 2022, 29(1): e12733. DOI: 10.1111/xen.12733.
    [15]
    MOHIUDDIN MM, SINGH AK, SCOBIE L, et al. Graft dysfunction in compassionate use of genetically engineered pig-to-human cardiac xenotransplantation: a case report[J]. Lancet, 2023, 402(10399): 397-410. DOI: 10.1016/S0140-6736(23)00775-4.
    [16]
    BALIGA RR. Genetically modified porcine-to-human cardiac xenotransplantation[J]. N Engl J Med, 2022, 387(14): 1337-1338. DOI: 10.1056/NEJMc2210401.
    [17]
    MOAZAMI N, STERN JM, KHALIL K, et al. Pig-to-human heart xenotransplantation in two recently deceased human recipients[J]. Nat Med, 2023, 29(8): 1989-1997. DOI: 10.1038/s41591-023-02471-9.
    [18]
    PORRETT PM, ORANDI BJ, KUMAR V, et al. First clinical-grade porcine kidney xenotransplant using a human decedent model[J]. Am J Transplant, 2022, 22(4): 1037-1053. DOI: 10.1111/ajt.16930.
    [19]
    MONTGOMERY RA, STERN JM, LONZE BE, et al. Results of two cases of pig-to-human kidney xenotransplantation[J]. N Engl J Med, 2022, 386(20): 1889-1898. DOI: 10.1056/NEJMoa2120238.
    [20]
    LOUPY A, GOUTAUDIER V, GIARRAPUTO A, et al. Immune response after pig-to-human kidney xenotransplantation: a multimodal phenotyping study[J]. Lancet, 2023, 402(10408): 1158-1169. DOI: 10.1016/S0140-6736(23)01349-1.
    [21]
    NIH National Library of Medicine. Porcine kidney xenotransplantation in patients with end-stage kidney disease[EB/OL]. [2023-10-01]. https://clinicaltrials.gov/study/NCT05340426.
    [22]
    LEE K, FARRELL K, UH K. Application of genome-editing systems to enhance available pig resources for agriculture and biomedicine[J]. Reprod Fertil Dev, 2019, 32(2): 40-49. DOI: 10.1071/RD19273.
    [23]
    PETERSEN B, FRENZEL A, LUCAS-HAHN A, et al. Efficient production of biallelic GGTA1 knockout pigs by cytoplasmic microinjection of CRISPR/Cas9 into zygotes[J]. Xenotransplantation, 2016, 23(5): 338-346. DOI: 10.1111/xen.12258.
    [24]
    COOPER DKC. What will be the cost of a genetically-engineered pig organ for clinical xenotransplantation?[J]. Xenotransplantation, 2020, 27(5): e12606. DOI: 10.1111/xen.12606.
    [25]
    刘圣圳, 董隽, 罗光达, 等. 机器人辅助腹腔镜活体供肾切取术(附2例报告)[J]. 微创泌尿外科杂志, 2015(2): 75-77. DOI: 10.3969/j.issn.2095-5146.2015.02.003.

    LIU SZ, DONG J, LUO GD, et al. Robotic-assisted living donor nephrectomy (two cases of reports)[J]. J Minim Invasive Urol, 2015(2): 75-77. DOI: 10.3969/j.issn.2095-5146.2015.02.003.
    [26]
    董隽, 卢锦山, 祖强, 等. 改良手辅助后腹腔镜活体供肾切取术(附视频)[J/CD]. 中华移植杂志(电子版), 2010, 4(3): 219-220. DOI: 10.3877/cma.j.issn.1674-3903.2010.03.010.

    DONG J, LU JS, ZU Q, et al. Modified hand-assisted retrolaparoscopic living donor nephrectomy [J/CD]. Chin J Transplant (Electr Edit), 2010, 4(3): 219-220. DOI: 10.3877/cma.j.issn.1674-3903.2010.03.010.
    [27]
    OZTURK SA, YUKSEL Y, ERBIS H, et al. Laparoscopic live donor nephrectomy: experience of high-volume center with 2, 477 cases[J]. Urol Int, 2021, 105(1/2): 100-107. DOI: 10.1159/000511377.
    [28]
    TIONG HY, GOH BYS, CHIONG E, et al. Robotic kidney autotransplantation in a porcine model: a procedure-specific training platform for the simulation of robotic intracorporeal vascular anastomosis[J]. J Robot Surg, 2018, 12(4): 693-698. DOI: 10.1007/s11701-018-0806-5.
    [29]
    王西墨. 猪到猕猴异种肾移植的实验研究[D]. 湖北: 华中科技大学, 2001. DOI: 10.7666/d.y392889.
    [30]
    郭霜, 李选鹏, 满江位, 等. 手助后腹腔镜和开放活体供肾切取术的临床分析[J]. 微创泌尿外科杂志, 2019, 8(1): 1-6. DOI: 10.19558/j.cnki.10-1020/r.2019.01.001.

    GUO S, LI XP, MAN JW, et al. Clinical analysis of hand-assisted retroperitoneoscopic and open living donor nephrectomy[J]. J Minim Invasive Urol, 2019, 8(1): 1-6. DOI: 10.19558/j.cnki.10-1020/r.2019.01.001.
    [31]
    雷永生, 王志伟, 王钢, 等. 后腹腔镜右侧活体供肾切取术单中心经验[J/CD]. 中华移植杂志(电子版), 2020, 14(4): 234-236. DOI: 10.3877/cma.j.issn.1674-3903.2020.04.008.

    LEI YS, WANG ZW, WANG G, et al. Single center experience in retrolaparoscopic right living donor nephrectomy [J/CD] . Chin J Transplant (Electr Edit), 2020, 14(4): 234-236. DOI: 10.3877/cma.j.issn.1674-3903.2020.04.008.
    [32]
    DAGNÆS-HANSEN J, KRISTENSEN GH, STROOMBERG HV, et al. Surgical approaches and outcomes in living donor nephrectomy: a systematic review and meta-analysis[J]. Eur Urol Focus, 2022, 8(6): 1795-1801. DOI: 10.1016/j.euf.2022.03.021.
    [33]
    WINDISCH OL, MATTER M, PASCUAL M, et al. Robotic versus hand-assisted laparoscopic living donor nephrectomy: comparison of two minimally invasive techniques in kidney transplantation[J]. J Robot Surg, 2022, 16(6): 1471-1481. DOI: 10.1007/s11701-022-01393-x.
    [34]
    NEWMAN ME, MUSK GC, HE B. Establishment of laparoscopic live donor nephrectomy in a porcine model: techniques and outcomes in 44 pigs[J]. J Surg Res, 2018, 222: 132-138. DOI: 10.1016/j.jss.2017.09.042.
    [35]
    GKEKA K, TSATURYAN A, FAITATZIADIS S, et al. Robot-assisted radical nephrectomy using the novel avatera robotic surgical system: a feasibility study in a porcine model[J]. J Endourol, 2023, 37(3): 273-278. DOI: 10.1089/end.2022.0596.
    [36]
    PELEGRIN T, CHAMPY CM, GERBAUD F, et al. Robotic-assisted laparoscopy living donor nephrectomy: technique and results of a monocentric retrospective series[J]. Prog Urol, 2022, 32(8/9): 567-576. DOI: 10.1016/j.purol.2022.03.009.
    [37]
    KOGA S, YAMANAGA S, HIDAKA Y, et al. Influence of graft ureter length, a donor-related factor, on urinary tract infections after living-donor kidney transplantation: a single-center analysis of 211 cases[J]. Transpl Int, 2022, 35: 10754. DOI: 10.3389/ti.2022.10754.
    [38]
    FOOTE JB, BIKHET MH, HANSEN-ESTRUCH C, et al. Observations on hydronephrosis after pig kidney transplantation in baboons[J]. Xenotransplantation, 2022, 29(6): e12779. DOI: 10.1111/xen.12779.
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