A single-aortotomy end-to-side technique simplifies murine aortic transplantation

Transplant arteriosclerosis remains a major cause of late graft failure after solid organ transplantation. Murine aortic transplantation models have provided important insights into the mechanisms underlying chronic allograft rejection, but the surgical procedure remains technically demanding. We developed a modified end-to-side aortic transplantation technique utilizing a single recipient aortotomy to simplify vascular anastomosis in mice.

Recipient infrarenal aortas were occluded proximally and distally using microvascular clamps. A single longitudinal aortotomy was created in the recipient infrarenal aorta. The proximal and distal ends of a donor thoracic aortic graft were independently anastomosed end-to-side to this single opening. Following completion of the anastomoses, a central ligature was placed between the donor graft inlet and outlet tracts to direct blood flow through the graft. Operative outcomes were compared with those of the conventional (two-aortotomy) end-to-side technique.

Donor harvest times were similar between groups. Recipient preparation time was shorter with the single-aortotomy technique (10.07 ± 0.95 vs. 10.87 ± 1.17 min, p = 0.033). Anastomosis time was significantly reduced compared with the conventional technique (14.73 ± 1.24 vs. 20.40 ± 1.57 min, p < 0.0001). Graft patency was 93% versus 87%, thrombosis occurred in one animal per group, and survival was comparable between techniques.

A single-aortotomy end-to-side configuration significantly reduces anastomosis time while maintaining graft patency, survival, and the ability to reproduce transplant vasculopathy. This technique provides a simplified and reproducible approach for murine aortic transplantation.