title: Pig kidney transplantation: an up-to-date guideline.
abstract: BACKGROUND
  Swine and human beings have many aspects in common that make swine a well-characterized large animal model for kidney transplantation (KTx). However, pigs have some peculiar anatomical characteristics that standardized techniques must adapt to. The aim of this study was to prepare an up-to-date guideline for porcine KTx.
  
  
  METHODS
  To achieve this goal, we performed a Medline search using the terminology 'kidney' or 'renal' and 'transplantation' and 'pig' or 'swine' or 'porcine'. We found over 1,300 published articles since 1963. Only 13 studies focused on the surgical aspect. Furthermore, we reviewed related books and articles about swine anatomical characteristics and surgery. Finally, our experimental experiences of KTx during the last few decades were added to this collection.
  
  
  RESULTS
  Proper hosting, fasting, anesthesia, medical therapy and monitoring can prevent postoperative complications. Explantation with a Carrel patch of the aorta facilitates the implantation and prevents future stenosis. Native nephrectomy makes the follow-up of the implanted organ more precise. KTx in the infrarenal fossa via end-to-side anastomosis to the aorta and inferior vena cava followed by ureteroureterostomy are the recommended options for KTx in pigs compared to other possible methods.
  
  
  CONCLUSIONS
  Pigs, with respect to their characterizations, constitute one of the best large animal models for KTx. Preoperative preparations are as important as the intra- and postoperative management. Using the most adaptable methods of surgery with respect to the specific anatomical characteristics of pigs can prevent undermining the studies and avoid preventable complications and pitfalls.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Golriz
authors.forename: H
authors.initials: H
authors.lastname: Fonouni
authors.forename: A
authors.initials: A
authors.lastname: Nickkholgh
authors.forename: M
authors.initials: M
authors.lastname: Hafezi
authors.forename: C
authors.initials: C
authors.lastname: Garoussi
authors.forename: A
authors.initials: A
authors.lastname: Mehrabi
mesh_terms: D000818:Animals; D016030:Kidney Transplantation / Q000379:methods*; D023421:Models, Animal; D009392:Nephrectomy; D019990:Perioperative Care; D013552:Swine / Q000601:surgery*