A Comprehensive Review on the Surgical Aspect of Lung Transplant Models in Mice and Rats

Abstract

Lung transplantation improves the outcome and quality of life of patients with end-stage pulmonary disease. However, the procedure is still hampered by the lack of suitable donors, the complexity of the surgery, and the risk of developing chronic lung allograft dysfunction. Over the past decades, translational experiments in animal models have led to a better understanding of physiology and immunopathology following the lung transplant procedure. Small animal models (e.g., rats and mice) are mostly used in experiments regarding immunology and pathobiology and are preferred over large animal models due to the ethical aspects, the cost-benefit balance, and the high throughput possibility. In this comprehensive review, we summarize the reported surgical techniques for lung transplantation in rodent models and the management of perioperative complications. Furthermore, we propose a guide to help identify the appropriate species for a given experiment and discuss recent experimental findings in small animal lung transplant models.

Keywords: lung transplantation; microsurgery; mouse; rat; rodent; small animal model.

Figure 1

Donor procedure in rats LTx. (A) The chest wall is flipped outward with forceps and fixed on both sides. (B) Stabilizer with needle holder. (C) Benchwork for preparing donor lung. (D) The vessel is passed through the cuff, and tissue is folded over the cuff body and secured with a 7-0 nylon suture. (E) The bronchus is cuffed the same way as the vessels. (F) The bulldog clamp is set into foam blocks as a stabilizer for cuffing vessels and bronchus [25]. PV—pulmonary vein; B—bronchus; PA—pulmonary artery.

Figure 2

Recipient procedure in mice LTx. (A) Right decubitus position of recipient. (B) The hilum is exposed using a curved micro serrefine. (C) Occlusion of PV and PA using a slipknot. Triangles indicate the branches of the PV. (D) B and PA are ligated with a circumferential suture. (E) Cuffs after implantation and reperfusion. PV—pulmonary vein; B—bronchus; PA—pulmonary artery.