Laparoscopic transplantation of metanephros: A first step to kidney xenotransplantation

• Published in: Actas urológicas españolas (English ed.) Vol. 39; no. 9; pp. 527 - 534
• Main Authors: Vera-Donoso, C.D, García-Dominguez, X, Jiménez-Trigos, E, García-Valero, L, Vicente, J.S, Marco-Jiménez, F
• Format: Journal Article
• Language: English
• Published: Elsevier España 01.11.2015
• Subjects: Immunosuppression; Inmunosupresión; Kidney transplantation; Laparoscopia; Laparoscopy; Trasplante renal; Urology; Xenotransplantation; Xenotrasplantes; Inmunosupresión; Xenotrasplantes; Immunosuppression; Trasplante renal; Xenotransplantation; Laparoscopy; Laparoscopia; Kidney transplantation
• ISSN: 2173-5786; 2173-5786
• DOI: 10.1016/j.acuroe.2015.09.006

Abstract Background Embryonic kidney xenotransplantation could represent a new solution to the scarcity of kidneys for transplantation. Objective To determine the feasibility of allogeneic laparoscopic transplantation of metanephros (M) in rabbits. Materials and methods Microscopic dissection was conducted to obtain metanephros from 14-day-old (24 M), 15-day-old (20 M) and 16-day-old (26 M) embryos. Using single-port abdominal laparoscopy, a spinal needle was inserted percutaneously, through which the metanephros were deposited (using an epidural catheter) close to a patent blood vessel in the retroperitoneal fat. Seventy metanephros were transplanted to 18 rabbits. Three weeks later, the animals were examined through open surgery. We compared the embryonic maturity, the morphometric variables of the metanephros and the development rate of the transplanted metanephros. Results The lower time limit for the extraction of metanephros from the rabbits was day 14. Three weeks after transplantation, only 3/24 14-day-old metanephros grew at minimal expression (12.5%). In contrast, 10/20 (50%) 15-day-old and 12/26 (46.1%) 16-day-old metanephros grew. These metanephros had differentiated sufficiently toward normal glomeruli, proximal and distal tubules and collecting ducts. We detected no relevant immunological changes in the peripheral blood. Conclusions We have described for the first time in the literature the allogeneic laparoscopic transplantation of metanephros from embryos as a feasible and noninvasive technique. The recipients did not require immunosuppression.