Experience of transplantation of the kidney, ureter and part of the bladder as a single block in the experiment

Gani Kuttymuratov, Ardak Ainakulov, Kuat Oshakbayev, Askar Ayaganov, Arman Mirmanov

Korean Journal of Transplantation, 2023

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DOI 10.4285/atw2023.f-7707
Data confidence 70 medium
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Abstract

In cases of microcystis with terminal kidney damage, the potential recipient undergoes augmentative or reconstructive cystoplasty to increase the bladder volume before transplantation. A few months later this recipient undergoes the second surgical intervention kidney transplantation. The performance of bladder augmentation surgeries with subsequent transplantation is accompanied by technical difficulties, has a number of complications and drawbacks. Methods: The study was conducted on pigs in the amount of six individuals. Pigs were divided into two groups three donors and three recipients, each of which was each other's siblings. All operations were performed under general anesthesia. One kidney with a ureter, a part of the bladder and a second ureter without a kidney were taken from the donors as a single block. After perfusion and preservation, the organs were implanted into the recipients. All recipients received antibacterial, symptomatic therapy. After the operation, they were kept in separate cages, where they were fed, watered, and washed. Killing and disposal of animals were carried out in compliance with all bioethical norms and rules. Results: Seven days after the operation, the efficiency and survival of transplanted organs were assessed in the recipients visually and by histological examination of tissues under general anesthesia. In all cases, the function of the graft, the condition of the bladder was satisfactory. In one case, failure of the uretero-ureteroanastomosis was noted against the background of necrosis of the wall of the ureter of the graft. The picture of the histological examination showed moderate circulatory disorders of the part of the bladder in all cases. Conclusions: This study allows us to introduce this technology into clinical transplantation to solve the problem of choosing an effective method of bladder reconstruction, thereby improving the quality and increasing life expectancy, reduce disability in children and adult patients with a shriveled bladder with terminal kidney disease.