Mastering mouse lung transplantation from scratchda track record Yukio Tsushima, MD, PhD, a,b Jae-Hwi Jang, PhD, a Moritz C. Wurnig, MD, MSc, c Andreas Boss, MD, c Kenji Suzuki, MD, PhD, b Walter Weder, MD, a and Wolfgang Jungraithmayr, MD a, * a Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland b Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan c Department of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland article info Article history: Received 13 April 2013 Received in revised form 10 May 2013 Accepted 24 May 2013 Available online 19 June 2013 Keywords: Mouse Lung transplantation Complications abstract Background: Mouse lung transplantation has evolved into an established scientific model that is currently used by an increasing number of research groups. Acquiring this tech- nique without previous microsurgical knowledge is considered very difficult. Disclosing all the intraoperative failures and mistakes during the model’s evolution will encourage all researchers who lack microsurgical skills that overcoming and eventually succeeding in this model is possible. Methods: Inbred (C57BL/6, BALB/c, SVG129) and CD1-outbred mice served as the transplant donors and recipients. The training procedure was performed by a surgeon not experi- enced in microsurgery, and arranged as follows: donor preparation until proof of func- tionality, graft implantation into deceased recipients, and graft implantation into surviving recipients until stable performance was achieved. The transplant’s viability was controlled using micro-computed tomography imaging. Results: Donor preparation complications decreased from 43% after 1 month to 0% after 2 mo. The first functional donor was implanted at day 28, and the first successful implantation into a surviving recipient was performed at day 60 after six training recipi- ents. Micro-computed tomography confirmed a ventilated and perfused graft. Intra- operative complications, mainly due to anastomosis failure, decreased from 58% after the first month to 15% at the latest assessment. The most recent implantation time was 75  4.8 min, and the transplantation success rate was 82%  2.8%. A modified forceps considerably improved completion of the venous anastomosis. Conclusions: Consistent success in the mouse lung transplantation model can be achieved even without pre-existing microsurgical skills. The surgery can be mastered within a reasonable period using a limited number of training animals. Procedure-related complications can be restricted to a minimum by applying key corrective steps at critical phases. This should encourage investigators without pre-expert knowledge in microsur- gery to start to learn this research model. ª 2013 Elsevier Inc. All rights reserved. * Corresponding author. Division of Thoracic Surgery, University Hospital Zurich, Raemistrasse 100, Zurich CH-8091 Switzerland. Tel.: þ41 44 255 88 02; fax: þ41 44 255 88 05. E-mail address: wolfgang.jungraithmayr@usz.ch (W. Jungraithmayr). Available online at www.sciencedirect.com journal homepage: www.JournalofSurgicalResearch.com journal of surgical research 185 (2013) 426 e432 0022-4804/$ e see front matter ª 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jss.2013.05.091