Transplante multivisceral em suínos: modelo de pesquisa e treinamento

• Autor(a) principal: David, Andre Ibrahim
• Data de Publicação: 2011
• Outros Autores: Chida, Valeria Vieira, Lee, Andre Dong Won, Fiuza, Felipe Soares Oliveira Rodrigues, Calil, Daniela Medeiros, Mantovani, Danielle de Carvalho, Maranhão, Eduardo Rullo, Campi, Gabriel Beligni, Llanos, Juan Carlos [UNESP], Ferraz Neto, Jose Ben Hur
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://dx.doi.org/10.1590/S1679-45082011AO1956; http://hdl.handle.net/11449/136810
• topic: Transplants/methods; Viscera/transplants; Animal models; Professional training; Swine; Transplantes/métodos; Vísceras/transplante; Modelos animais; Capacitação profissional; Suínos

Objective: To present a model for research and training in multivisceral transplantation in pigs. Methods: Eight Large White pigs (four donors and four recipients) were operated. The multivisceral transplant with stomach, duodenum, pancreas, liver and intestine was performed similarly to transplantation in humans with a few differences, described below. Anastomoses were performed as follows: end-to-end from the supra-hepatic vena cava of the graft to the recipient juxta diaphragmatic vena cava; end-to-end from the infra-hepatic vena cava of the graft to the inferior (suprarenal) vena cava of the recipient; and endto-side patch of the aorta of the graft to the infrarenal aorta of the recipient plus digestive reconstruction. Results: The performance of the multivisceral transplantion was possible in all four animals. Reperfusions of the multivisceral graft led to a severe ischemia-reperfusion syndrome, despite flushing of the graft. The animals presented with hypotension and the need for high doses of vasoactive drugs, and all of them were sacrificed after discontinuing these drugs. Conclusion: Some alternatives to minimize the ischemia-reperfusion syndrome, such as the use of another vasoactive drug, use of a third pig merely for blood transfusion, presence of an anesthesia team in the operating room, and reduction of the graft, will be the next steps to enable experimental studies.