title: Mastering mouse lung transplantation from scratch--a track record.
abstract: BACKGROUND
  Mouse lung transplantation has evolved into an established scientific model that is currently used by an increasing number of research groups. Acquiring this technique without previous microsurgical knowledge is considered very difficult. Disclosing all the intraoperative failures and mistakes during the model's evolution will encourage all researchers who lack microsurgical skills that overcoming and eventually succeeding in this model is possible.
  
  
  METHODS
  Inbred (C57BL/6, BALB/c, SVG129) and CD1-outbred mice served as the transplant donors and recipients. The training procedure was performed by a surgeon not experienced in microsurgery, and arranged as follows: donor preparation until proof of functionality, graft implantation into deceased recipients, and graft implantation into surviving recipients until stable performance was achieved. The transplant's viability was controlled using micro-computed tomography imaging.
  
  
  RESULTS
  Donor preparation complications decreased from 43% after 1 month to 0% after 2 mo. The first functional donor was implanted at day 28, and the first successful implantation into a surviving recipient was performed at day 60 after six training recipients. Micro-computed tomography confirmed a ventilated and perfused graft. Intraoperative complications, mainly due to anastomosis failure, decreased from 58% after the first month to 15% at the latest assessment. The most recent implantation time was 75 ± 4.8 min, and the transplantation success rate was 82% ± 2.8%. A modified forceps considerably improved completion of the venous anastomosis.
  
  
  CONCLUSIONS
  Consistent success in the mouse lung transplantation model can be achieved even without pre-existing microsurgical skills. The surgery can be mastered within a reasonable period using a limited number of training animals. Procedure-related complications can be restricted to a minimum by applying key corrective steps at critical phases. This should encourage investigators without pre-expert knowledge in microsurgery to start to learn this research model.
authors.affiliation: Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland; Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Tsushima
authors.forename: Jae-Hwi
authors.initials: JH
authors.lastname: Jang
authors.forename: Moritz C
authors.initials: MC
authors.lastname: Wurnig
authors.forename: Andreas
authors.initials: A
authors.lastname: Boss
authors.forename: Kenji
authors.initials: K
authors.lastname: Suzuki
authors.forename: Walter
authors.initials: W
authors.lastname: Weder
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Jungraithmayr
mesh_terms: D000714:Anastomosis, Surgical / Q000193:education / Q000379:methods; D000818:Animals; D021461:Animals, Outbred Strains; D006085:Graft Survival; D007431:Intraoperative Complications / Q000517:prevention & control; D008168:Lung / Q000000981:diagnostic imaging / Q000601:surgery; D016040:Lung Transplantation / Q000193:education* / Q000379:methods*; D051379:Mice; D057507:Mice, 129 Strain; D008807:Mice, Inbred BALB C; D008810:Mice, Inbred C57BL; D008866:Microsurgery / Q000193:education* / Q000379:methods*; D023421:Models, Animal; D061646:Operative Time; D011183:Postoperative Complications / Q000517:prevention & control; D013047:Specific Pathogen-Free Organisms; D055114:X-Ray Microtomography
keywords: Complications; Lung transplantation; Mouse