Anterior hilum anastomosis versus posterior hilum anastomosis in a mouse lung transplantation model

Jin Zhao; Dong Tian; Xiucheng Yang; Mingzhao Liu; JingYu Chen

doi:10.1016/j.xjtc.2022.04.019

Anterior hilum anastomosis versus posterior hilum anastomosis in a mouse lung transplantation model

JTCVS Tech. 2022 Apr 22:14:159-165. doi: 10.1016/j.xjtc.2022.04.019. eCollection 2022 Aug.

Authors

Jin Zhao¹, Dong Tian², Xiucheng Yang¹, Mingzhao Liu¹, JingYu Chen^{1

3}

Affiliations

¹ Wuxi Lung Transplant Center, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China.
² Department of Thoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
³ Department of Lung Transplantation, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.

Abstract

Objectives: The mouse orthotopic lung transplantation (LTx) model is of enormous research value in lung transplantation. This study compares 2 anastomotic methods (anterior and posterior hilum anastomosis) of mouse LTx in term of difficulty, operation time, and postoperative effects.

Methods: Twenty mice received LTx with slipknots for anterior hilum anastomosis (AH group), and 28 received LTx with a microvessel clip for posterior hilum anastomosis (PH group), all by a single surgeon. The operation time was recorded and the grafts were evaluated 24 hours after surgery.

Results: The success rates in the recipient animals were 85% (17/20) in AH group and 89% (25/28) in PH group (P > .05). The recipient operation time and back table time in AH group were longer than those in PH group (52.8 ± 5.0 vs 47.3 ± 5.7 minutes, 27.8 ± 3.9 vs 25.3 ± 2.8 minutes, P < .05), but the warm ischemia time did not differ significantly (13.1 ± 2.1 vs 12.2 ± 2.6 minutes, P = .258), meaning that the time discrepancies predominantly originated from the hilum treatment. In AH group, 2 cases failed due to pulmonary venous thrombosis and atelectasis respectively at 24 hours after LTx, but none failed in PH group. No significant difference was observed in the postoperative performance of the successful recipients (thoracic radiographs, macroscopic appearance, oxygenation index, pulmonary compliance, pathologic changes) between the 2 groups.

Conclusions: Compared with anterior hilar anastomosis, posterior hilum anastomosis with a microvessel clip is less complicated and less time-consuming in the management of hilar structures and causes fewer postoperative complications.

Keywords: AH, anterior hilum; Br, bronchus; Fio2, inspired oxygen fraction; H&E, hematoxylin and eosin; LPD, low-potassium dextran; LTx, lung transplantation; PA, pulmonary artery; PH, posterior hilum; PV, pulmonary vein; anterior hilum anastomosis; mouse orthotopic lung transplantation; posterior hilum anastomosis.