title: Revised Arterial Anastomosis for Improving Murine Kidney Transplant Outcomes.
abstract: OBJECTIVE
  One of the most challenging research microsurgical techniques is the mouse kidney transplant however, very few laboratories have made use of this important model due to its difficulty. One of the main obstacles to utilizing this procedure is the high incidence of post-operative arterial thrombosis. We believe this is caused by the path in which blood is required to flow from the recipient abdominal aorta, via the donor recipient aorta and on into the renal artery creating a tortuous route and areas of turbulence, which are prone to thrombus formation and failure of the graft.
  
  
  METHODS
  We describe revised methods of donor artery recovery, whereby the traditional transection of the donor aorta is replaced with a heel and toe cuff, which is created by dividing the donor abdominal aorta obliquely across the face of the renal arterial ostium, which then provides for an arterial end-to-side anastomosis of a scale similar to that used for the heterotopic heart model. This technique produces an anastomosis that facilitates free blood flow from the recipient abdominal aorta at less than 90° thereby reducing the likelihood of thrombus formation.
  
  
  RESULTS
  Utilizing this new technique the incidence of arterial thrombosis has decreased from 35% to 0% (n = 20 and 24, respectively) with no change in ischemia times.
  
  
  CONCLUSIONS
  We describe a revised method of performing the arterial anastomosis during mouse kidney transplantation, which facilitates improved fluid dynamics by straightening the flow path for blood to the graft resulting in significantly reduced thrombus formation, excellent graft function, histology, and post-transplant survival.
authors.affiliation: 1Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Denver, Aurora, Colorado, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Plenter
authors.forename: Swati
authors.initials: S
authors.lastname: Jain
authors.forename: Trevor L
authors.initials: TL
authors.lastname: Nydam
authors.forename: Alkesh H
authors.initials: AH
authors.lastname: Jani
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D001012:Aorta, Abdominal / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D008866:Microsurgery / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D012077:Renal Artery / Q000601:surgery*; D012078:Renal Artery Obstruction / Q000517:prevention & control; D012079:Renal Circulation; D015427:Reperfusion Injury / Q000517:prevention & control; D013927:Thrombosis / Q000517:prevention & control; D019737:Transplants / Q000098:blood supply; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*
keywords: graft; mouse; renal