Construction of porcine DCD marginal donor model and pathological observation of donor kidney

Abstract

Objective To construct a marginal donor model of porcine donation after cardiac death (DCD), and evaluate the pathological alteration of DCD donor kidneys. Methods Seven male mini pigs (4~6 months old, 13~17 kg) were divided into standard donor control group (C group, n=3) and DCD group (n=4). After intramuscular injection with phenobarbital sodium, their auricular vein channels were established, then propofol and sufentanil were injected to enhance the anesthetic induction while blood pressure, electrocardiogram and oxygen saturation (SaO2) were monitored at the same time. Group C received mechanical ventilation after endotracheal intubation, and maintained anesthesia with propofol, remifentanil and cisatracurium, and the kidneys were harvested under laparotomy. In the DCD group, 300 IU/kg heparin was injected intravenously for anticoagulation, followed by single bolus venous injection with 600 mg propofol and 10 mg cisatricurium to induce cardiac and respiratory arrest, and finally, the kidneys were harvested in 30 min after cardiac arrest. The kidneys in both groups were cut into small tissues, which were further fixed with 4% paraformaldehyde, embedded in paraffin wax and stained with HE for the pathological assessment and tissue damage scores under a optical microscope. Results The mean time for SaO2 to decline to 80% was 3.25±1.89 min and the mean time for cardiac arrest was 7.75±3.10 min in the 4 pigs of DCD group after injection with overdose of anesthetics. Compared with the C group, the renal tubular injury score of DCD marginal donor kidney after suffering from warm ischemia for 30 min, was higher (P < 0.05), and the mean score of glomerular injury was increased through no statistical difference. Conclusion Intravenous injection of excessive propofol and cisatracurium can effectively establish a porcine DCD marginal donor model.

Keywords

• donation after cardiac death
• marginal donor
• organ transplantation
• animal model
• swine