The First Case Of Laparoscopic Stem Cell-Generated Embryonic Kidney Transplantation In Pig

You have accessJournal of UrologyRenal Transplantation & Vascular Surgery I (MP37)1 Sep 2021MP37-02 THE FIRST CASE OF LAPAROSCOPIC STEM CELL-GENERATED EMBRYONIC KIDNEY TRANSPLANTATION IN PIG Hiroshi Sasaki, Satomi Iwai, Tsuyoshi Takamura, Syutarou Yamamoto, Shin Egawa, Takashi Yokoo, and Eiji Kobayashi Hiroshi SasakiHiroshi Sasaki More articles by this author , Satomi IwaiSatomi Iwai More articles by this author , Tsuyoshi TakamuraTsuyoshi Takamura More articles by this author , Syutarou YamamotoSyutarou Yamamoto More articles by this author , Shin EgawaShin Egawa More articles by this author , Takashi YokooTakashi Yokoo More articles by this author , and Eiji KobayashiEiji Kobayashi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002046.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Our group has previously reported the effective growth of a urine excretion pathway in stem cell-generated embryonic kidneys from a transplanted embryonic pig cloaca, which is a metanephros with a bladder and which developed and produced urine, by open surgery in pig [1]. It is crucial to establish a less invasive transplantation method when operating on humans. Herein, we report the first case of laparoscopic stem cell-generated embryonic kidney transplantation in pig. METHODS: We used two female microminiature pigs (Fuji Micra Ltd., Shizuoka, Japan), aged 30 months. An endoscope system (CLV-U400, Olympus Co., Ltd, Tokyo, Japan) with a 5-mm, zero-degree endoscope was utilized for the laparoscopic procedures. We started surgery with three trocars. First, the abdominal aorta and the left kidney were identified. The transplant site was located in the vicinity of the renal artery divergence region. We cut the peritoneum and made two incisions of <10 mm to create transplant pockets. Two cloacas were transplanted at these sites. To accurately transplant the cloaca, a novel laparoscopic transplant-grasping device system, which can place the pig cloaca at the transplantation site by releasing a few drops of saline solution from the attached tube, was used. In addition, we transplanted two cloacas into the greater omentum of each pig as well. The development of the transplanted tissue was examined histopathologically by dissection after 4 weeks. RESULTS: Median operative time was 78 minutes. The cloacas were accurately transplanted into the targeted sites in both cases using a novel laparoscopic transplant-grasping device system. No perioperative adverse events were observed. We confirmed the growth of the kidney and bladder tissue from the cloaca via histopathological assessment. CONCLUSIONS: This was the first laparoscopic cloaca transplantation in pig. In a laparoscopic/robotic-assisted cloaca transplantation, it is crucial to transplant the cloaca into the target site without damaging it. Therefore, the establishment of standardized laparoscopic implantation methods and improvement of laparoscopic forceps will facilitate the achievement of this goal. Source of Funding: This work was partly supported by the Japan Agency for Medical Research and Development. Reference 1. , et al. PNAS 2015; 112(42):12980. Google Scholar © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e645-e646 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hiroshi Sasaki More articles by this author Satomi Iwai More articles by this author Tsuyoshi Takamura More articles by this author Syutarou Yamamoto More articles by this author Shin Egawa More articles by this author Takashi Yokoo More articles by this author Eiji Kobayashi More articles by this author Expand All Advertisement PDF downloadLoading ...