title: Gastrostomy tube placement for long-term oral drug administration in non-human primates.
abstract: Non-human primates (NHPs) are often used as recipients in preclinical transplantation research that in most cases involves administration of various drugs including immunosuppressants. Long-term oral drug administration, particularly tacrolimus, is challenging in the transplant recipient NHPs. Oral drug administration method using the mixture of drug and fruit juice has been used in NHPs, but this is not always effective in all monkeys. To those monkeys who are poorly compliant, oral drug administration in restraint or administration using gastrostomy tube should be necessary. The aim of this study was to compare the efficacy of between oral drug administration in restraint and administration using gastrostomy tube and to report complications and solutions to overcome the problems related to gastrostomy tube for long-term oral drug dosing in rhesus monkeys.
  
  
  
  Fifteen of 4- to 5-year-old male and female healthy rhesus monkeys weighing 5.0-6.8 kg were used as recipients for porcine pancreatic islet transplantation. Oral drug administration in restraint was used for four monkeys, and gastrostomy tube was placed to other 11 monkeys (8-French Feeding tube, n=6; Tri-Funnel Replacement Gastrostomy tube, n=5). Oral immunosuppressive drugs such as sirolimus and tacrolimus were administered through the tube. The efficacy and the extent of ease for administration and related complications were compared between two groups.
  
  
  
  The complication of gastrostomy included a transient inflammation in the skin and peritonitis caused by a leakage around implantation site (one case), which could be overcome by changing suture method and tube type to interlocking box suture and Tri-Funnel Replacement Gastrostomy tube, respectively. Despite these complications, oral drug administration using gastrostomy tube allowed us to perform accurate dosage of drug administration and to reduce the stress that both the monkey and the researcher may experience. Taken together, this study showed that gastrostomy tube placement is a better alternative to oral drug administration in restraint for long-term oral drug administration in rhesus monkeys who tend to refuse to eat the mixture of drug and fruit juice.
authors.affiliation: Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.|Institute of Endemic Diseases, Seoul National University Graduate School, Seoul, Korea.|Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.|Institute of Endemic Diseases, Seoul National University Graduate School, Seoul, Korea.|Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.|Department of Microbiology and Immunology, Seoul National University Graduate School, Seoul, Korea.|Cancer Research Institute, Seoul National University Graduate School, Seoul, Korea.
authors.forename: Jun-Seop
authors.initials: JS
authors.lastname: Shin
authors.affiliation: Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.|Department of Microbiology and Immunology, Seoul National University Graduate School, Seoul, Korea.|Cancer Research Institute, Seoul National University Graduate School, Seoul, Korea.
authors.forename: Byoung-Hoon
authors.initials: BH
authors.lastname: Min
authors.affiliation: Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.|Institute of Endemic Diseases, Seoul National University Graduate School, Seoul, Korea.|Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.|Department of Microbiology and Immunology, Seoul National University Graduate School, Seoul, Korea.|Cancer Research Institute, Seoul National University Graduate School, Seoul, Korea.
authors.forename: Jung-Sik
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.|Department of Microbiology and Immunology, Seoul National University Graduate School, Seoul, Korea.|Cancer Research Institute, Seoul National University Graduate School, Seoul, Korea.
authors.forename: Il-Hee
authors.initials: IH
authors.lastname: Yoon
authors.affiliation: Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.
authors.forename: Won-Young
authors.initials: WY
authors.lastname: Jeong
authors.affiliation: Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.
authors.forename: Ga-Eul
authors.initials: GE
authors.lastname: Lee
authors.affiliation: Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.
authors.forename: Min-Sun
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.
authors.forename: Ju-Eun
authors.initials: JE
authors.lastname: Kim
authors.affiliation: Xenotransplantation Research Center, Seoul National University Graduate School, Seoul, Korea.|Institute of Endemic Diseases, Seoul National University Graduate School, Seoul, Korea.|Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.|Department of Microbiology and Immunology, Seoul National University Graduate School, Seoul, Korea.|Cancer Research Institute, Seoul National University Graduate School, Seoul, Korea.|Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea.
authors.forename: Chung-Gyu
authors.identifier: 0000-0003-4083-8791
authors.initials: CG
authors.lastname: Park
mesh_terms: D000284:Administration, Oral; D000818:Animals; D020878:Device Removal; D005260:Female; D005774:Gastrostomy / Q000379:methods; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000494:pharmacology; D008253:Macaca mulatta; D008297:Male; D011183:Postoperative Complications; D013995:Time; D014183:Transplantation, Heterologous / Q000379:methods
chemical_list: D007166:Immunosuppressive Agents
keywords: gastrostomy tube; oral drug administration; restrain; rhesus monkey