This work is supported by RO1 DK064938 (to T.H.).

<ol>
	<li>Shapiro, A. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Islet+transplantation+in+seven+patients+with+type+1+diabetes+mellitus+using+a+glucocorticoid-free+immunosuppressive+regimen.">Islet transplantation in seven patients with type 1 diabetes mellitus using a glucocorticoid-free immunosuppressive regimen.</a> N Engl J Med. 343, 230-238 (2000).</li><li>Weir, G. C., Bonner-Weir, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Islet+transplantation+as+a+treatment+for+diabetes.">Islet transplantation as a treatment for diabetes.</a> J Am Optom Assoc. 69, 727-732 (1998).</li><li>Gangemi, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Islet+transplantation+for+brittle+type+1+diabetes:+the+UIC+protocol.">Islet transplantation for brittle type 1 diabetes: the UIC protocol.</a> Am J Transplant. 8, 10-1111 (2008).</li><li>Zmuda, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Deficiency+of+ATF3,+an+adaptive-response+gene,+protects+islets+and+ameliorates+inflammation+in+a+syngenic+transplantation+model.">Deficiency of ATF3, an adaptive-response gene, protects islets and ameliorates inflammation in a syngenic transplantation model.</a> Diabetologia. , (2010).</li><li>Bottino, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Response+of+Human+Islets+to+Isolation+Stress+and+the+Effect+of+Antioxidant+Treatment.">Response of Human Islets to Isolation Stress and the Effect of Antioxidant Treatment.</a> Diabetes. 53, 2559-2568 (2004).</li><li>Markmann, J. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effect+of+islet+cell+culture+in+vitro+at+24+degrees+C+on+graft+survival+and+MHC+antigen+expression.">The effect of islet cell culture in vitro at 24 degrees C on graft survival and MHC antigen expression.</a> Transplantation. 49, 272-277 (1990).</li><li>Terasaka, R., Lacy, P. E., Hauptfeld, V., Bucy, R. P., Davie, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effect+of+cyclosporin-A,+low-temperature+culture,+and+anti-Ia+antibodies+on+prevention+of+rejection+of+rat+islet+allografts.">The effect of cyclosporin-A, low-temperature culture, and anti-Ia antibodies on prevention of rejection of rat islet allografts.</a> Diabetes. 35, 83-88 (1986).</li><li>Ricordi, C., Lacy, P. E., Sterbenz, K., Davie, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Low-temperature+culture+of+human+islets+or+in+vivo+treatment+with+L3T4+antibody+produces+a+marked+prolongation+of+islet+human-to-mouse+xenograft+survival.">Low-temperature culture of human islets or in vivo treatment with L3T4 antibody produces a marked prolongation of islet human-to-mouse xenograft survival.</a> Proc Natl Acad Sci U S A. 84, 8080-8084 (1987).</li><li>Schnedl, W. J., Ferber, S., Johnson, J. H., Newgard, C. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=STZ+transport+and+cytotoxicity.+Specific+enhancement+in+GLUT2-expressing+cells.">STZ transport and cytotoxicity. Specific enhancement in GLUT2-expressing cells.</a> Diabetes. 43, 1326-1333 (1994).</li><li>Eckhard, M., Brandhorst, D., Brandhorst, H., Brendel, M. D., Bretzel, R. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Optimization+in+osmolality+and+range+of+density+of+a+continuous+ficoll-sodium-diatrizoate+gradient+for+isopycnic+purification+of+isolated+human+islets.">Optimization in osmolality and range of density of a continuous ficoll-sodium-diatrizoate gradient for isopycnic purification of isolated human islets.</a> Transplantation Proceedings. 36, 2849-2854 (2004).</li><li>Gores, P. F., Rabe, F., Sutherland, D. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prolonged+survival+of+intraportal+versus+subrenal+capsular+transplanted+islet+allografts.">Prolonged survival of intraportal versus subrenal capsular transplanted islet allografts.</a> Transplantation. 43, 747-749 (1987).</li><li>Nasr, I. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Testicular+Immune+Privilege+Promotes+Transplantation+Tolerance+by+Altering+the+Balance+between+Memory+and+Regulatory+T+Cells.">Testicular Immune Privilege Promotes Transplantation Tolerance by Altering the Balance between Memory and Regulatory T Cells.</a> J Immunol. 174, 6161-6168 (2005).</li><li>Merani, S., Toso, C., Emamaullee, J., Shapiro, A. M. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Optimal+implantation+site+for+pancreatic+islet+transplantation.">Optimal implantation site for pancreatic islet transplantation.</a> British Journal of Surgery. 95, 1449-1461 (2008).</li><li>Inoue, M., Maeno, T., Hatchell, D. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Survival+of+allografted+pancreatic+islets+in+the+subretinal+space+in+rats.">Survival of allografted pancreatic islets in the subretinal space in rats.</a> Ophthalmic Res. 35, 48-53 (2003).</li></ol>

No conflicts of interest declared.

In the sections above, we described detailed steps for isolating and transplanting the mouse pancreatic islets. Here, we briefly highlight the steps that are critical for the success of the procedures.
1. Islet isolation
The key steps are identifying an optimal enzymatic digestion time (1.4), positioning the hemostat clamp over the duodenal opening of the common bile duct (2.2.3), cannulating the common bile duct (2.3), vigorous shaking of the pancreas after the 37&deg;C digest (3.2), and removal of exocrine cell contamination (3.3.7 and 3.3.16). These steps have a dramatic influence on the quality, yield and purity of islets. Perhaps the most technically challenging step is the cannulation of the common bile duct. In many mice, the common bile duct can be difficult to visualize due to surrounding fascia. Therefore, it is common that attempts to cannulate the common bile duct result in penetration of the fascia tissue only. In these instances, the Liberase begins to fill the surrounding connective tissue and does not perfuse the pancreas. If this is observed, stop the flow of Liberase and reposition the needle so that it penetrates into the lumen of the bile duct. With practice, it is possible to quickly identify the optimal position for needle placement and to complete the cannulation without damaging the friable duct.
2. Islet transplantation
The critical steps are the STZ induction of diabetes (5.1) and the efficient delivery of islets to the subcapsular pouch (5.3.14-5.3.16). STZ is a naturally occurring glucose analogue that is selectively toxic to the insulin secreting cells &beta;-cells of islets 9. However, this selective toxicity occurs in a relatively narrow concentration range. This is evidenced by the fact that high doses of STZ can result in rapid (2-3 days) lethality in the absence of hyperglycemia. Therefore, care should be taken to identify the optimal dose of STZ for the strain and age of mice being used before any large scale experiments are initiated. The physical delivery of the islets to the subcapsular pouch is also a key step. To achieve consistent results, it is imperative to minimize the loss of islets during their delivery. This can occur if there are defects or tears in the kidney capsule covering the pouch or if the injected volume is too large. Damage to the capsule can be avoided by gentle and careful manipulation, and by using smooth glass probe to prepare the subcapsular pouch. Additionally, the injection volume can be minimized with careful removal of the supernatant in step 5.3.6.3. If the supernatant is removed down to the level of the sedimented islets, there is typically more than enough room in the subcapsular pouch to place 400 to 500 islets. However, if the injection volume is too large, the islets are more likely to leak out of the pouch during the transplant process, compromising the reproducibility of the experiment.
Within this protocol, it is possible to modify some of the steps and still achieve satisfactory outcomes. These include the following: (a) the use of a different enzyme to digest the pancreas, (b) a different method for delivering the enzyme to the pancreas, (c) the use of a continuous Ficoll-sodium-diatrizoate (FSD) gradient instead of the single density Histopaque1077 step, and (d) islet transplantation to locations other than the kidney subcapsule.
<ol class="lalpha">
	<li>In this protocol, Liberase is used to weaken the cell-cell contacts within the pancreas. Liberase is essentially a mixture of highly purified collagenases that have proven useful in releasing islets from the pancreas. However, less purified collagenases are capable of accomplishing a similar result. Therefore, it is possible to use different commercially available enzyme preparations for digesting the pancreas, as long as the digestion condition is optimized to achieve high islet quality, yield and purity.</li>
	<li>It is also possible to digest the pancreas without ductal perfusion of enzyme. Delivery of Liberase through the common bile duct allows for maximal exposure of pancreatic surface area to the enzyme. This results in more even digestion of the pancreas and greater release of intact islets. However, other steps to increase the surface area of the pancreas to the enzyme can be used. For example, mincing the pancreas before incubating it in Liberase or directly injecting Liberase through the pancreatic capsule can be used to isolate islets. However, no other method of Liberase delivery is as effective as perfusion through the common bile duct. Therefore, mincing or direct injection should be reserved as a last resort, if the common bile duct is damaged and not perfusable.</li>
	<li>An alternative method for separating the islets from the exocrine cells involves the use of a FSD gradient instead of Histopaque1077 10. The efficient separation of islets from exocrine cells in this protocol is in part due to a density differential between the two cell types. Histopaque1077 has a density of 1.0771 g/ml at 25&deg;C. At this temperature, Histopaque is denser than the islets but less dense than the exocrine cells. Therefore, under the force of centrifugation, Histopaque1077 pellets the exocrine cells while lifting the islets to the surface. In principle, any other substance with a density that that can separate islets from exocrine cells can be used in this step and the FSD gradient is one such substance.</li>
	<li>With respect to the location for islets transplantation, the kidney capsule used in this protocol is one of the few possible sites. While the kidney subcapsule is the most commonly reported site of transplantation in mice, other transplantation sites have been found to be effective and they include the hepatic portal vein, subretinal space, testis, epididymal fat pad, spleen, and even pancreas 11-14. Each of these locations has their own advantages and challenges. Therefore, the selection of a site for islet transplantation should be determined by the questions addressed and specific circumstances of the experiments.</li>
</ol> 
It is believed that strategies that can overcome the limitations on islet transplantation will dramatically enhance its therapeutic potential. Therefore, the use of a murine model as detailed by this protocol offers an attractive approach for identifying such strategies.

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">	
		
		<div>
		<table border="1">
		<thead>
		<tr>
		<th>Material Name</th>
		<th>Type</th>
		<th>Company</th>
		<th>Catalogue Number</th>
		<th>Comment</th>
		</tr>
		</thead>
		<tbody>
		
<tr>
<td>RPMI 1640</td>
<td>Reagent</td>
<td>Gibco</td>
<td>31800-022</td>
<td>&nbsp;</td>
<tr>
<td>Liberase TL</td>
<td>Reagent</td>
<td>Roche</td>
<td>05401020001</td>
<td>&nbsp;</td>
<tr>
<td>Fetal Bovine Serum</td>
<td>Reagent</td>
<td>Gibco</td>
<td>10437-028</td>
<td>&nbsp;</td>
<tr>
<td>Histopaque1077</td>
<td>Reagent</td>
<td>Sigma Aldrich</td>
<td>10771</td>
<td>&nbsp;</td>
<tr>
<td>Penicillin Streptomycin </td>
<td>Reagent</td>
<td>Gibco</td>
<td>15140</td>
<td>&nbsp;</td>
<tr>
<td>Sodium Citrate</td>
<td>Reagent</td>
<td>Sigma Aldrich</td>
<td>S4641</td>
<td>&nbsp;</td>
<tr>
<td>Streptozotocin</td>
<td>Reagent</td>
<td>Sigma Aldrich</td>
<td>S-0130</td>
<td>&nbsp;</td>
<tr>
<td>HCl</td>
<td>Reagent</td>
<td>Fisher Scientific</td>
<td>A144-212</td>
<td>&nbsp;</td>
<tr>
<td>Isoflurane</td>
<td>Reagent</td>
<td>Vedco</td>
<td>ISOSOL</td>
<td>&nbsp;</td>
<tr>
<td>Glass Capillary Tubes</td>
<td>Equipment</td>
<td>Fisher Scientific</td>
<td>22362574</td>
<td>&nbsp;</td>
<tr>
<td>Insulin Syringe</td>
<td>Equipment</td>
<td>BD Falcon</td>
<td>329461</td>
<td>&nbsp;</td>
<tr>
<td>27 Gauge Syringe Needle</td>
<td>Equipment</td>
<td>BD Falcon</td>
<td>305109</td>
<td>&nbsp;</td>
<tr>
<td>Hamilton Syringe #1702</td>
<td>Equipment</td>
<td>Fisher Scientific</td>
<td>14813133</td>
<td>&nbsp;</td>
<tr>
<td>10cm Petri Plates</td>
<td>Equipment</td>
<td>Fisher Scientific</td>
<td>0875712</td>
<td>&nbsp;</td>
<tr>
<td>6cm Petri Plates</td>
<td>Equipment</td>
<td>Fisher Scientific</td>
<td>07770212</td>
<td>&nbsp;</td>
<tr>
<td>6-0 Suture</td>
<td>Equipment</td>
<td>Ethicon</td>
<td>8726H</td>
<td>&nbsp;</td>
<tr>
<td>PE 50 Flexible Tubing</td>
<td>Equipment</td>
<td>Fisher Scientific</td>
<td>NC9083963</td>
<td>&nbsp;</td>
<tr>
<td>5ml Disposable Syringe</td>
<td>Equipment</td>
<td>BD Falcon</td>
<td>309603</td>
<td>&nbsp;</td>
<tr>
<td>50ml Conical Tube</td>
<td>Equipment</td>
<td>BD Falcon</td>
<td>352098</td>
<td>&nbsp;</td>
<tr>
<td>15ml Conical Tube</td>
<td>Equipment</td>
<td>BD Falcon</td>
<td>352097</td>
<td>&nbsp;</td>
<tr>
<td>0.1mm Nylon Mesh</td>
<td>Equipment</td>
<td>Fisher Scientific</td>
<td>22363549</td>
<td>&nbsp;</td>
<tr>
<td>0.419mm Wire Mesh</td>
<td>Equipment</td>
<td>Newark Wire Cloth Company</td>
<td>0300241</td>
<td>&nbsp;</td>
<tr>
<td>Water Bath Incubator</td>
<td>Equipment</td>
<td>Fisher Scientific</td>
<td>15-462-5</td>
<td>&nbsp;</td>
<tr>
<td>Dissecting Microscope</td>
<td>Equipment</td>
<td>Zeiss</td>
<td>Stemi SV6</td>
<td>&nbsp;</td>
<tr>
<td>Inverted Microscope</td>
<td>Equipment</td>
<td>Nikon</td>
<td>TMS</td>
<td>&nbsp;</td>
<tr>
<td>Tissue Culture Incubator</td>
<td>Equipment</td>
<td>Napco</td>
<td>6300</td>
<td>&nbsp;</td>
<tr>
<td>Dissecting Scissors</td>
<td>Equipment</td>
<td>Kent Scientific</td>
<td>INS14393</td>
<td>&nbsp;</td>
<tr>
<td>McPherson-Vannas Scissors</td>
<td>Equipment</td>
<td>Kent Scientific</td>
<td>INS500260</td>
<td>&nbsp;</td>
<tr>
<td>Curved Forceps</td>
<td>Equipment</td>
<td>Kent Scientific</td>
<td>INS15915</td>
<td>&nbsp;</td>
<tr>
<td>Hemostatic Forceps</td>
<td>Equipment</td>
<td>Kent Scientific</td>
<td>INS 500451</td>
<td>&nbsp;</td>
<tr>
<td>Isoflurane Nebulizer</td>
<td>Equipment</td>
<td>Smiths Medical Surgivet</td>
<td>ISOTech 4 OHMEDA</td>
<td>&nbsp;</td>
<tr>
<td>Swing Bucket Centrifuge</td>
<td>Equipment</td>
<td>Dupont &#x2013; Sorvall</td>
<td>RT6000D</td>
<td>&nbsp;</td>
<tr>
<td>Swing Bucket Rotor</td>
<td>Equipment</td>
<td>Dupont &#x2013; Sorvall</td>
<td>H1000B</td>
<td>&nbsp;</td>
<tr>
<td>pH Meter</td>
<td>Equipment</td>
<td>Mettler Toledo/ Fisher Scientific</td>
<td>09313509</td>
<td>&nbsp;</td>
<tr>
<td>Gel Loading Tips</td>
<td>Equipment</td>
<td>Fisher Scientific</td>
<td>05408151</td>
<td>&nbsp;</td>
<tr>
<td>p200 Tips</td>
<td>Equipment</td>
<td>USA Scientific</td>
<td>111-0730</td>
<td>&nbsp;</td>		</tbody>
		</table>
		</div>

a method for murine islet isolation and subcapsular kidney transplantation

Since the early pioneering work of Ballinger and Reckard demonstrating that transplantation of islets of Langerhans into diabetic rodents could normalize their blood glucose levels, islet transplantation has been proposed to be a potential treatment for type 1 diabetes 1,2. More recently, advances in human islet transplantation have further strengthened this view 1,3. However, two major limitations prevent islet transplantation from being a widespread clinical reality: (a) the requirement for large numbers of islets per patient, which severely reduces the number of potential recipients, and (b) the need for heavy immunosuppression, which significantly affects the pediatric population of patients due to their vulnerability to long-term immunosuppression. Strategies that can overcome these limitations have the potential to enhance the therapeutic utility of islet transplantation.
Islet transplantation under the mouse kidney capsule is a widely accepted model to investigate various strategies to improve islet transplantation. This experiment requires the isolation of high quality islets and implantation of islets to the diabetic recipients. Both procedures require surgical steps that can be better demonstrated by video than by text. Here, we document the detailed steps for these procedures by both video and written protocol. We also briefly discuss different transplantation models: syngeneic, allogeneic, syngeneic autoimmune, and allogeneic autoimmune.

Watch this Scientific Journal Video about A Method for Murine Islet Isolation and Subcapsular Kidney Transplantation at JoVE.com

A Method for Murine Islet Isolation and Subcapsular Kidney Transplantation

Transplantation of isolated islets has been proposed to be a potential treatment for type 1 diabetes. Here we describe a method to isolate islets from mouse pancreata and transplant them to the subcapsular space of the kidney.

Since the early pioneering work of Ballinger and Reckard demonstrating that transplantation of islets of Langerhans into diabetic rodents could normalize ...

a-method-for-murine-islet-isolation-subcapsular-kidney

Nanyang Technological University

Research

JoVE Journal

Medicine

63.3K Views.  The Ohio State University. Transplantation of isolated islets has been proposed to be a potential treatment for type 1 diabetes. Here we describe a method to isolate islets from mouse pancreata and transplant them to the subcapsular space of the kidney.

Video: A Method for Murine Islet Isolation and Subcapsular Kidney Transplantation

Development of Obliterative Bronchiolitis in a Murine Model of Orthotopic Lung Transplantation

Orthotopic lung transplantation in rats was first reported by Asimacopoulos and colleagues in 1971 1. Currently, this method is well accepted and standardized not only for the study of allo-rejection but also between syngeneic strains for examining mechanisms of ischemia-reperfusion injury after lung transplantation. Although the application of the rat and other large animal model 2 contributed significantly to the elucidation of these studies, the scope of those investigations is limited by the scarcity of knockout and transgenic rats. Due to no effective therapies for obliterative bronchiolitis, the leading cause of death in lung transplant patients, there has been an intensive search for pre-clinical models that replicate obliterative bronchiolitis. The tracheal allograft model is the most widely used and may reproduce some of the histopathologic features of obliterative bronchiolitis 3. However, the lack of an intact vasculature with no connection to the recipient's conducting airways, and incomplete pathologic features of obliterative bronchiolitis limit the utility of this model 4. Unlike transplantation of other solid organs, vascularized mouse lung transplants have only recently been reported by Okazaki and colleagues for the first time in 2007 5. Applying the basic principles of the rat lung transplant, our lab initiated the obliterative bronchiolitis model using minor histoincompatible antigen murine orthotopic single-left lung transplants which allows the further study of obliterative bronchiolitis immunopathogenesis6.

Obliterative bronchiolitis is the key impediment to the long-term survival of lung transplant recipients and the lack of a robust preclinical model precludes examining obliterative bronchiolitis immunopathogenesis. Unlike other solid organ transplants, vascularized mouse lung transplantation has only recently been developed. Here we show our independently developed obliterative bronchiolitis model after murine orthotopic single-lung transplantation.

Orthotopic lung transplantation in rats was first reported by Asimacopoulos and colleagues in 1971 1. Currently, this method is well accepted and ...

Murine Cervical Heart Transplantation Model Using a Modified Cuff Technique

Mouse models are of special interest in research since a wide variety of monoclonal antibodies and commercially defined inbred and knockout strains are available to perform mechanistic in vivo studies. While heart transplantation models using a suture technique were first successfully developed in rats, the translation into an equally widespread used murine equivalent was never achieved due the technical complexity of the microsurgical procedure. In contrast, non-suture cuff techniques, also developed initially in rats, were successfully adapted for use in mice1-3. This technique for revascularization involves two major steps I) everting the recipient vessel over a polyethylene cuff; II) pulling the donor vessel over the formerly everted recipient vessel and holding it in place with a circumferential tie. This ensures a continuity of the endothelial layer, short operating time and very high patency rates4.
Using this technique for vascular anastomosis we performed more than 1,000 cervical heart transplants with an overall success rate of 95%. For arterial inflow the common carotid artery and the proximal aortic arch were anastomosed resulting in a retrograde perfusion of the transplanted heart. For venous drainage the pulmonary artery of the graft was anastomosed with the external jugular vein of the recipient5.
Herein, we provide additional details of this technique to supplement the video.

The murine cervical heart transplantation model is well suited for immunological as well as ischemia reperfusion injury studies. We modified the procedure using a non-suture cuff technique and performed more than 1,000 successful transplants with this approach.
Herein, we provide additional details of this technique to supplement the video.

Mouse models are of special interest in research since a wide variety of monoclonal antibodies and commercially defined inbred and knockout strains are ...

Murine Heterotopic Heart Transplant Technique

It is now over forty years since this technique was first reported by Corry, Wynn and Russell. Although it took some years for other labs to become proficient in and utilize this technique, it is now widely used by many laboratories around the world. A significant refinement to the original technique was developed and reported in 2001 by Niimi. Described here are the techniques that have evolved over more than a decade in the hands of three surgeons (Plenter, Grazia, Pietra) in our center. These techniques are now being passed on to a younger generation of surgeons and researchers.
Based largely on the Niimi experience, the procedures used have evolved in the fine details - details which we will endeavor to relate here in such a way that others may be able to use this very useful model. Like Niimi, we have found that a video aid to learning is a priceless resource for the beginner.

The manuscript describes the steps required to perform the heterotopic heart transplant in the mouse.

It is now over forty years since this technique was first reported by Corry, Wynn and Russell. Although it took some years for other labs to become ...

Murine Corneal Transplantation: A Model to Study the Most Common Form of Solid Organ Transplantation

Corneal transplantation is the most common form of organ transplantation in the United States with between 45,000 and 55,000 procedures performed each year. While several animal models exist for this procedure and mice are the species that is most commonly used. The reasons for using mice are the relative cost of using this species, the existence of many genetically defined strains that allow for the study of immune responses, and the existence of an extensive array of reagents that can be used to further define responses in this species. This model has been used to define factors in the cornea that are responsible for the relative immune privilege status of this tissue that enables corneal allografts to survive acute rejection in the absence of immunosuppressive therapy. It has also been used to define those factors that are most important in rejection of such allografts. Consequently, much of what we know concerning mechanisms of both corneal allograft acceptance and rejection are due to studies using a murine model of corneal transplantation. In addition to describing a model for acute corneal allograft rejection, we also present for the first time a model of late-term corneal allograft rejection.

Mice have been used as a model for studying many forms of transplantation, including corneal transplantation. We describe in this report a murine model for both acute and late-term corneal transplantation.

Corneal transplantation is the most common form of organ transplantation in the United States with between 45,000 and 55,000 procedures performed each ...

Mouse Kidney Transplantation: Models of Allograft Rejection

Rejection of the transplanted kidney in humans is still a major cause of morbidity and mortality. The mouse model of renal transplantation closely replicates both the technical and pathological processes that occur in human renal transplantation. Although mouse models of allogeneic rejection in organs other than the kidney exist, and are more technically feasible, there is evidence that different organs elicit disparate rejection modes and dynamics, for instance the time course of rejection in cardiac and renal allograft differs significantly in certain strain combinations. This model is an attractive tool for many reasons despite its technical challenges. As inbred mouse strain haplotypes are well characterized it is possible to choose donor and recipient combinations to model acute allograft rejection by transplanting across MHC class I and II loci. Conversely by transplanting between strains with similar haplotypes a chronic process can be elicited were the allograft kidney develops interstitial fibrosis and tubular atrophy. We have modified the surgical technique to reduce operating time and improve ease of surgery, however a learning curve still needs to be overcome in order to faithfully replicate the model. This study will provide key points in the surgical procedure and aid the process of establishing this technique.

Here, we present a protocol to study the immunology of rejection. The surgical model presented reports a short operating time and a concise technique. Depending on the donor-recipient strain combination, the transplanted kidney may develop acute cellular rejection or chronic allograft damage, defined by interstitial fibrosis and tubular atrophy.

Rejection of the transplanted kidney in humans is still a major cause of morbidity and mortality. The mouse model of renal transplantation closely ...

Murine Kidney Transplant Technique

The first mouse kidney transplant technique was published in 19731 by the Russell laboratory. Although it took some years for other labs to become proficient in and utilize this technique, it is now widely used by many laboratories around the world. A significant refinement to the original technique using the donor aorta to form the arterial anastomosis instead of the renal artery was developed and reported in 1993 by Kalina and Mottram 2 with a further advancement coming from the same laboratory in 1999 3. While one can become proficient in this model, a search of the literature reveals that many labs still experience a high proportion of graft loss due to arterial thrombosis. We describe here a technique that was devised in our laboratory that vastly reduces the arterial thrombus reported by others 4,5. This is achieved by forming a heel-and-toe cuff of the donor infra-renal aorta that facilitates a larger anastomosis and straighter blood flow into the kidney.

The goal of this manuscript is to describe the steps required to perform a kidney transplant in a mouse, paying particular attention to the details of the arterial anastomosis.

The first mouse kidney transplant technique was published in 19731 by the Russell laboratory. Although it took some years for other labs to become ...

Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation

Kidney transplantation has become a well-established treatment option for patients with end-stage renal failure. The persisting organ shortage remains a serious problem. Therefore, the acceptance criteria for organ donors have been extended leading to the usage of marginal kidney grafts. These marginal organs tolerate cold storage poorly resulting in increased preservation injury and higher rates of delayed graft function. To overcome the limitations of cold storage, extensive research is focused on alternative normothermic preservation methods.
Ex vivo normothermic organ perfusion is an innovative preservation technique. The first experimental and clinical trials for ex vivo lung, liver, and kidney perfusions demonstrated favorable outcomes.
In addition to the reduction of cold ischemic injury, the method of normothermic kidney storage offers the opportunity for organ assessment and repair. This manuscript provides information about kidney retrieval, organ preservation techniques, and isolated ex vivo normothermic kidney perfusion (NEVKP) in a porcine model. Surgical techniques, set up for the perfusion solution and the circuit, potential assessment options, and representative results are demonstrated.

Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation

The severe organ shortage has resulted in increased use of marginal kidney grafts for transplantation. This has triggered interest in alternative storage methods, since marginal grafts especially tolerate cold storage poorly. The technique of normothermic ex vivo kidney perfusion (NEVKP) represents a novel preservation method for kidney grafts prior to &#160;transplantation.

Kidney transplantation has become a well-established treatment option for patients with end-stage renal failure. The persisting organ shortage remains a ...

A Novel Clinical Grade Isolation Method for Human Kidney Perivascular Stromal Cells

Mesenchymal Stromal Cells (MSCs) are tissue homeostatic and immune modulatory cells that have shown beneficial effects in kidney diseases and transplantation. Perivascular Stromal Cells (PSCs) share characteristics with bone marrow MSCs (bmMSCs). However, they also possess, most likely due to local imprinting, tissue-specific properties and play a role in local tissue homeostasis. This tissue specificity may result in tissue specific repair, also within the human kidney. We previously showed that human kidney PSCs (kPSCs) have enhanced kidney epithelial wound healing whereas bmMSCs did not have this potential. Moreover, kPSCs can ameliorate kidney injury in vivo. Therefore, kPSCs constitute an interesting source for cell therapy, particularly for kidney diseases and renal transplantation. Here we show the detailed isolation and culture method for kPSCs from transplant-grade human kidneys based on whole-organ perfusion of digestive enzymes via the renal artery and enrichment for the perivascular marker NG2. In this way, large cell quantities can be obtained that are suitable for cellular therapy.

Here we present a novel clinical grade isolation and culture method for kidney Perivascular Stromal Cells (kPSCs) based on whole organ perfusion with digestive enzymes and NG2-cell enrichment. With this method, it is possible to acquire sufficient cell numbers for cellular therapy.

Mesenchymal Stromal Cells (MSCs) are tissue homeostatic and immune modulatory cells that have shown beneficial effects in kidney diseases and ...

Orthotopic Rat Kidney Transplantation: A Novel and Simplified Surgical Approach

Kidney transplantation offers increased survival rates and improved quality of life for patients with end-stage renal disease, as compared to any type of renal replacement therapy. Over the past few decades, the rat kidney transplantation model has been used to study the immunological phenomena of rejection and tolerance. This model has become an indispensable tool to test new immunomodulatory pharmaceuticals and regimens prior to proceeding with expensive preclinical large animal studies.
This protocol provides a detailed overview of how to reliably perform orthotopic kidney transplantation in rats. This protocol includes three distinctive steps that increase the probability of success: perfusion of the donor kidney by flushing through the portal vein and the use of a cuff system to anastomose the renal veins and ureters, thereby decreasing cold and warm ischemia times. Using this technique, we have achieved survival rates beyond 6 months with normal serum creatinine in animals with syngeneic or tolerant kidney transplants. Depending on the aim of the study, this model can be modified by pre- or posttransplant treatments to study the acute, chronic, cellular, or antibody-mediated rejection. It is a reproducible, reliable, and cost-effective animal model to study different aspects of kidney transplantation.

The purpose of this manuscript and protocol is to explain and demonstrate in detail the surgical procedure of orthotopic kidney transplantation in rats. This method is simplified to achieve the correct perfusion of the donor kidney and shorten the reperfusion time by using the venous and ureteral cuff anastomosis technique.

Kidney transplantation offers increased survival rates and improved quality of life for patients with end-stage renal disease, as compared to any type of ...

Optical Clearing and Imaging of Immunolabeled Kidney Tissue

Optical clearing techniques render tissue transparent by equilibrating the refractive index throughout a sample for subsequent three-dimensional (3-D) imaging. They have received great attention in all research areas for the potential to analyze microscopic multicellular structures that extend over macroscopic distances. Given that kidney tubules, vasculature, nerves, and glomeruli extend in many directions, which have been only partially captured by traditional two-dimensional techniques so far, tissue clearing also opened up many new areas of kidney research. The list of optical clearing methods is rapidly growing, but it remains difficult for beginners in this field to choose the best method for a given research question. Provided here is a simple method that combines antibody labeling of thick mouse kidney slices; optical clearing with cheap, non-toxic and ready-to-use chemical ethyl cinnamate; and confocal imaging. This protocol describes how to perfuse kidneys and use an antigen-retrieval step to increase antibody- binding without requiring specialized equipment. Its application is presented in imaging different multicellular structures within the kidney, and how to troubleshoot poor antibody penetration into tissue is addressed. We also discuss the potential difficulties of imaging endogenous fluorophores and acquiring very large samples and how to overcome them. This simple protocol provides an easy-to-setup and comprehensive tool to study tissue in three dimensions.

The combination of antibody labeling, optical clearing, and advanced light microscopy allows three-dimensional analysis of complete structures or organs. Described here is a simple method to combine immunolabeling of thick kidney slices, optical clearing with ethyl cinnamate, and confocal imaging that enables visualization and quantification of three-dimensional kidney structures.

Optical clearing techniques render tissue transparent by equilibrating the refractive index throughout a sample for subsequent three-dimensional (3-D) ...