A simple novel technique for heterotopic intestinal transplantation in mice

The murine heterotopic intestinal transplant model is of particular value for addressing the unique immune response in the gut and addressing the underlying immune mechanism during transplantation. Anastomotic stenosis, anastomotic bleeding, and septic shock continue to hamper procedures and plague the success. In this study, we assessed a refined technique designed to improve the success of heterotopic intestinal transplant in mice. Important factors in our refined technique included (1) a refined procedure for graft portal vein preparation, (2) a novel procedure for graft exteriorization, and most importantly (3) a knotless suturing technique designed to allow the surgeon to alter the size of the anastomosis, thus reducing anastomotic bleeding and stenosis rate. Our refined knotless method improved recipient survival to 67.5% when compared to the standard technique (53.8%). In comparison to standard knot suturing technique, which had an anastomotic stenosis rate of 8.3%, the knotless suturing technique significantly reduced the rate of anastomotic stenosis to only 2.4%. Anastomotic bleeding presented in the knotless technique in only 1.2%, whereas it presented in 6.2%, of mice in the standard technique (P < .05). This refined knotless technique offers an easy and effective method for murine heterotopic intestinal transplantation.