Introduction: Microcystis is a condition that is the outcome of various congenital or acquired diseases of the bladder, leading to a decrease in its capacity, and the main causes of the development of chronic renal failure.
The purpose of our study is to evaluate the effectiveness of transplantation of a donor kidney, ureters and part of the bladder en bloc to a recipient with simulated microcystis in an experiment on pigs.
Materials and methods: A total of 10 white Landrace pigs were used in the study. The animals were from the same sow and were siblings to each other. The pigs were 3-4 months old, weighing 35 - 45 kg, regardless of gender. The animals were divided into 5 donors and 5 recipients. After acclimatization of the animals for 10-14 days under endotracheal anesthesia, the left kidney with the ureter, part of the bladder and one third of the right ureter were removed from the donor as a single block. After the organs were perfused with a cooled solution. The recipients also underwent laparotomy, removal of the right kidney with ureter, part of the bladder to simulate microcystis and lower 1/3 of the right ureter. Then orthotopic transplantation of the removed organs was performed. In this case, part of the right ureter of the graft was anastomosed with the middle third ureter of the native left kidney, part of the graft bladder with part of the native bladder. During the operation, the animals were administered sedatives, antibiotic, and prednisolone. After surgery, recipients were monitored for 3-8 days. The pigs received antibacterial and symptomatic therapy. After 8 days, relaparotomy, visual assessment of the grafts and tissue biopsy for histological examination were performed. The animals were then euthanized
Results: Survival among 5 recipients was: 1 recipient - 3 days, 2 recipients - 5 days, 2 recipients - 8 days. The first “patient” underwent relaparotomy due to deterioration of his condition due to urinary leakage. During relaparotomy, necrosis of the bladder graft was observed. Histological examination also showed the presence of total necrosis of the tissue of the implanted bladder. In 2 recipients, on the 5th day after surgery, urinary leakage was also noted against the background of necrosis in the area of ​​the ureteroureteroanastomosis and part of the bladder with perforation of the wall, respectively. The remaining 2 pigs survived 8 days without complications and underwent relaparotomy. Visually, the anastomoses were consistent, the function of the grafts was satisfactory. The histological picture showed relatively satisfactory blood flow in the graft tissues.
Conclusions: This study showed that en bloc transplantation of the kidney, ureters and part of the bladder is feasible and has a good chance of continuing experimental work. In the future, we plan to continue the study and increase the number of operations to 30 cases. The pig is an excellent animal model for genitourinary organ transplantation research.