The operation of orthotopic renal allografting in the pig and its complications

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Abstract
Operating upon paired pigs simultaneously and performing bilateral nephrectomy with use of the left kidney for orthotopic renal allografting and pelviureteric anastomoses produces a constant, reproducible experimental model. The technique requires little practice and because of relative lack of anatomical variation in pigs has a high success rate. It is economical of animals and staff. Special postoperative support of the animals beyond normal animal husbandry practice is not required. This model has been used on 101 occasions. Seven operations were initial practice procedures and 94 operations were performed to evaluate various immunosuppressive agents (to be reported elsewhere). There were 11 technical failures, 5 of which, now that spinal-cord blood-flow is understood, would be much reduced in future series. Similarly 9 deaths with “no demonstrable cause” would be less with the understanding of post-transplantation lymph loss. The 3 deaths from preoperative feeding were nonrecurring factors. Failure within 36 hours was 25 per cent; experience and practice should reduce this to less than 10 per cent. Mean ischaemic time was 22 minutes; there was no demonstrable tubular necrosis up to 28 minutes.

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