A technical modification of heart-lung transplantation in rats

Needles to promote ventricular blood into the ischemic myocardium applied in a rat heart transplant model: an acute observation [corrected]

Two needles were designed in order to revascularize an ischemic myocardium in the event of left coronary artery occlusion. This study was conducted by performing the Lee modified Fox-Montorsi heart-lung transplant on 25 San Diego Microsurgical Institute-bred Sprague Dawley rats that were subjected to left coronary artery ligation in each case. Of these 25 rats, a straight-porous (SP) needling procedure was applied to 9 heterotopically transplanted rat hearts, and a distinct horseshoe (HS)-shaped needle application was performed on the remaining 16 heterotopically transplanted rat hearts. This report represents an acute study on the efficiency of these two needles to transmit oxygen-rich blood from the left ventricle into the ischemic myocardium. Doppler readings for male vs. female transplants showed that the control peak (PK) and mean (MN) kHz values are on the average of 0.20 kHz higher in males than in females. However, control heart rate values in both sexes are approximately equal. Ligation of the left coronary artery caused a dramatic decrease of PK and MN kHz values in both sexes, while heart rate showed no significant decrease from the original control values in response to ischemia. Application of the SP needle showed only a slight return of PK and MN values in both sexes, but heart rate values increased to levels higher than the original control values. The HS needling procedure was able to recover approximately 80% of the control PK and MN kHz values in both sexes. Thus, these data indicate that the HS needle can successfully transmit left ventricular blood into the myocardium.

A novel approach with magnetic resonance imaging used for the detection of lung allograft rejection

OBJECTIVE

Although various techniques have been explored for the detection and quantification of allograft transplant rejection, a practical and reliable method that is noninvasive is still elusive.

METHODS

For our magnetic resonance imaging experiments, we have developed a new rat model of heterotopic lung transplantation to the inguinal region. Allogeneic transplants (DA to Brown Norway) were performed with and without cyclosporine A (INN: ciclosporin) treatment, with syngeneic transplants (Brown Norway to Brown Norway) serving as controls (n = 6 per group). Magnetic resonance images were obtained with a gradient echo method before and after injection of ultra-small superparamagnetic iron oxide particles.

RESULTS

At day 5, allogeneic transplants without cyclosporine A treatment showed a grade 4 rejection histologically. A significantly lower magnetic resonance signal was seen 24 hours after injection of ultra-small superparamagnetic iron oxide particles compared with the preinjection image (346 +/- 7.6 vs 839 +/- 43.4 arbitrary units; P <. 05). Syngeneic transplants showed no evidence of rejection histologically and no differences in magnetic resonance imaging signals between the images before and after injection of ultra-small superparamagnetic iron oxide particles (863 +/- 18.8 vs 880 +/- 22.5). Allotransplants treated with cyclosporine A showed a grade 2 rejection histologically. The change in magnetic resonance signals in that group was small but showed a significant decrease in signal intensity after injection (646 +/- 10.5 vs 889 +/- 23.5, P <.05). Immunohistochemistry and iron staining of the allografts indicated that ultra-small superparamagnetic iron oxide particles were taken up by the infiltrating macrophages that accumulated at the rejection site.

CONCLUSIONS

We have demonstrated a novel approach for the detection of acute lung allograft rejection using magnetic resonance imaging coupled with injection of ultra-small superparamagnetic iron oxide particles. Despite its limitations, our method might be a first step toward a potential clinical application.

Review of significant microvascular surgical breakthroughs involving the heart and lungs in rats

Models of transplantation of the heart and lung in the rat have been important in determining the mechanisms of rejection and their treatment. Reviewed here are several important milestones contributing to the current state of the art of clinical heart and lung transplantation.

A new, biventricular working heterotopic heart transplant model: anatomic and physiologic considerations

BACKGROUND

Current heterotopic heart transplant models have nonworking left ventricles that atrophy and are not suitable for some studies. We developed and characterized a new heterotopic model with working left and right ventricles.

METHODS

Hemodynamics were compared in the working and nonworking models. The influence of the length of the donor's aorta on coronary arterial oxygenation was tested. The influence of the recipient's arterial pressure on developed left ventricular systolic pressure and the effects of alpha- and beta-adrenergic stimulation were examined in both models. The nonworking and working models were compared in chronic transplant preparations to investigate possible ventricular atrophy.

RESULTS

In this model, coronary arterial oxygen tension was influenced by the length of the donor's aorta. With a short donor aorta (0.5 cm in the porcine model), normal coronary arterial oxygenation is maintained. Left ventricular systolic pressure was greater in the working compared with the nonworking models. Left ventricular systolic pressure did not respond to alpha-adrenergic stimulation but did respond to beta-adrenergic and combined stimulation, which indicates its relationship to donor heart output. Left ventricular systolic pressure correlated with and was determined by recipient arterial pressure. Ventricular atrophy occurred in the nonworking model, but ventricular weight was maintained at sham control levels in this new working model.

CONCLUSION

These results demonstrate the surgical anatomic considerations of a new heterotopic heart transplant model in which the left and right ventricles work. Its hemodynamic performance is related to recipient hemodynamics, and the model responds to adrenergic stimulation. In chronic studies, ventricular mass is maintained, thus allowing this model to overcome a significant shortcoming of existing heterotopic heart transplant models.

Successful heterotopic heart transplantation in rat

Heterotopic heart transplantation in rats has become a substantial tool for numerous investigations. This report describes a surgical technique of infrarenal heterotopic heart transplantation with a prodigious surgical success rate which was developed over many years of practice. Difficulties arising from anatomic variations are depicted and alternative approaches are discussed.

Indium-labeled presensitized T cells for diagnosis of graft rejection

The aim of this experiment was to test a safe, noninvasive method for necessary, accurate diagnosis of early allograft rejection. Heart-lung allograft was performed heterotopically using Brown Norway (BN) rats as the donor and Lewis (LEW) rats as the recipient. T cell suspensions were prepared from lymphnodes of specifically sensitized LEW rats that had acutely rejected full-thickness BN skin graft. Cell count was adjusted 50 x 10(6) cells/ml. The suspension was incubated in vitro with 111I oxide (1 m Ci-ml). An aliquot of labeled cell suspension containing 40 x 10(6) cells and a total radioactivity of 200 mCi was administered intravenously to each animal 3 and 6 days after heart-lung transplant. The traffic of T cells was followed in vivo and in isolated organs under large field view gamma camera. The gamma camera revealed radioactivity on the graft starting Postoperative Day 5 when the heart was actively beating; no radioactivity was revealed at the site of the isografted organs. The histology showed mild to moderate cellular infiltration parallel to the grade of radioimaging intensity. The injection of indium-labeled presensitized T cells was able to detect the rejection process in an early phase when there are no clinical symptoms of rejection and/or the rejection cascade can be reversed. These results suggest that a similar method can be used in human organ transplantation for early diagnosis of rejection.

Comparative study of mouse heart and heart-lung transplantations

Heart transplantation in mice using a double anastomosis technique has become the standard method regardless of its technical difficulty. Heart-lung transplantation performed by single anastomosis in rats was also applied to mice, showing the identical operative result in addition to the advantage of easy applicability. We compared the heart transplant made by double anastomosis with the heart-lung transplantation using single aortic anastomosis in terms of graft survival and histologic features. The results were as follows: 1) During the follow-up period of 100 days after the transplantation in mice that survived 7 days after the operation, there were no deaths among the hosts and no evidence of nonfunction of the grafts in the six mice in each group. 2) In terms of monocyte infiltration perivascularily or interstitially, myocyte necrosis, interstitial hemorrhage, neutrophilic infiltration, and endocardial changes, histologic changes in the grafts were less in single anastomosis of heart-lung transplants than in double anastomosis. As a result, we can deduce that heart-lung transplantation using the single anastomosis technique is a good experimental model for the study of transplant reaction.

Allogeneic heart-lung transplantation in mice

Using a simpler technique for mouse heart and lung transplantation, a histological comparison was made between groups of syngeneic and allogeneic transplants. The initial high postoperative mortality encountered was due to technical difficulty and as the operative technique improved, mortality lessened. While direct palpation of the abdomen is the key means in the detection of graft rejection, there is no practical determination of such graft rejection other than histological clarification. Doppler tracing also is not a sensitive method for detecting rejection. The transplantation technique in this study compares the time of rejection of heart and lung transplants more legitimately.

Parameters altering the success of the one-anastomosis rat heart-lung transplant

The single-anastomosis heart-lung transplantation method in the rat developed by Lee and associates has been examined and has proven to be simple and reproducible. Technical procedures are discussed emphasizing those procedures that require special caution to ensure successful graft function. The donor and recipient rat strain combination has been found to influence the success of the transplantation procedure. Rat strain combinations used in our laboratories resulted in different percentages of donor heart survival. Using Lewis rat (RT1 1/1) recipients, 68% of Brown Norway rat (RT1n/n) donor hearts and 97% of NBR rat (RT1 1/1) donor hearts survived. However, only 29% of Fischer rat (RT1 1/1) donor hearts survived longer than 2 days when transplanted into Lewis rat recipients. In our laboratories, the Lee method of single-anastomosis heart-lung transplantation has been used successfully to evaluate whether immunoregulatory compounds alter heart allograft rejection.