Improved technique of vascular anastomosis for small intestinal transplantation in rats

AIM:To establish a new improved vascular anastomotic technique to simplify the surgical technique and increase the survival rate of small intestinal transplantation in rats.METHODS:The graft removed en bloc consisted of entire small intestine, portal vein and aortic segment with superior mesenteric artery. The graft was perfused in situ and the gut lumen was irrigated during the operation. Heterotopic small bowel transplantation was performed by microvascular end to side anastomosis between the donor aortic segment with superior mesenteric artery and the recipient abdominal aorta, and by the formation of a Cuff anastomosis between the donor portal vein and the recipient left renal vein. Both ends of the grafts were exteriorized as stomas.RESULTS:A total of 189 intestinal transplantations were performed in rats,33 of which were involved in the formal experimental group, with a survival rate of 84.8%. The average time for the donor surgery was 80min ± 10min; for graft repair 10min ± 3min; and for recipient surgery 95min ± 15min. The average time for the arterial anastomosis and the vein anastomosis was 18min ± 5min and 1min, respectively. The warm ischemic time and cold ischemic time were 22min ± 5min and less than 60min, respectively. The whole operation was completed by a single surgeon, the operative time being about 3 hours.CONCLUSION:The vascular anastomosis used in this study could simplify surgical technique, reduce the operative time and elevate the survival rate of small intestinal transplantation in rats.