Cervical heterotopic small intestinal transplantation in rats using artery sleeve anastomosis

Our goal was to establish a simple and stable cervical heterotopic small intestinal transplantation (SIT) rat model that minimizes mortality. Methods. The graft was removed en bloc consisting of small intestine, portal vein (PV), and donor superior mesenteric artery. The graft was perfused in situ and the gut lumen irrigated during the operation. The donor artery was end-to-end anastomosed to the recipient left common carotid artery using a sleeve technique, and the donor vein to the recipient right external jugular vein using a cuff technique. The proximal and distal ends of the graft were formed as cervical cutaneous stomas. Results. Among 106 intestinal transplantations, 40 were a formal experimental group, displaying a survival rate of 95%. Surgery lasted 70 +/- 10 minutes. The average time for the arterial anastomosis and the venous anastomosis was 5 +/- 2 minutes and 2 +/- 1 minutes, respectively. Two rats died due to late anastomotic hemorrhage or intestinal fistula; 38 survived more than 6 months. Conclusion. The cervical heterotopic technique has the advantages of being easier and faster to perform with shorter cold ischemia time and higher graft survival rate as well as fewer complications.