Experimental multivisceral xenotransplantation.
BACKGROUND
Organ shortage impairs the proposition of multivisceral transplantation to treat multiple organ failure. Interspecies (xeno) transplantation is a valid solution for organ shortage; however, suitable models of this advance are lacking. We describe an effective model of multivisceral xenotransplantation to study hyperacute rejection.


METHODS
Under general anesthesia, we in block recovered the distal esophagus, stomach, small bowel, colon, liver, pancreas, spleen, and kidneys from donors and implanted heterotopically in the lower abdomen of recipients. Animals were divided into four groups: I-canine donor, swine recipient (n = 6); II - swine donor, canine recipient (n = 5); III-canine donor, canine recipient (n = 4); and IV-swine donor, swine recipient (n = 5). Groups I and II comprised experimental (xenotransplantation) and III and IV control groups (allotransplantation). During the experiment, we appraised recipient evolution and graft modification by sequential biopsy up to 3 h. At this time, we killed animals for autopsy (experimental end point).


RESULTS
We accomplished all experiments successfully. Every grafts attained customary appearance and convenient urine output immediately after unclamp. Around 15 min after reperfusion, xenografts achieved signs of progressive hyperacute rejection and absence of urine output. At the end of experiments we observed moderate to severe hyperacute rejection at small bowel, colon, mesenteric lymph node, liver, spleen, pancreas, and kidney, while stomach and esophagus achieved mild lesions. In contrast, allograft achieved normal or minimum ischemia/reperfusion injury and constant urine output.


CONCLUSIONS
The present procedure assembles a simple and effective model to study multivisceral xenotransplantation and may ultimately spread researches toward hyperacute rejection.
Galvão
Flávio Henrique Ferreira
FH
Department of Gastroenterology, Service of Liver Transplantation, Faculdade de Medicinada Universidade de São Paulo, Sao Paulo, Brazil. fgalvao@usp.br
Pompeu
Eduardo
E
de Mello
Evandro Sobroza
ES
da Costa Lino Costa
Anderson
A
Mory
Eduardo
E
Dos Santos
Rafael Miyashiro
RM
Santos
Vinicius Rocha
VR
Machado
Marcel Cesar
MC
Bacchella
Telésforo
T
D000768:Anesthesia, General; D000818:Animals; D004285:Dogs; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000473:pathology; D006085:Graft Survival; D008297:Male; D016377:Organ Transplantation; D013552:Swine; D014183:Transplantation, Heterologous