Novel Cuff Design to Facilitate Anastomosis of Small Vessels During Cervical Heterotopic Heart Transplantation in Rats

Cervical heterotopic heart transplantation in rodents is a useful tool for studying transplantation immunology. However, end-to-end anastomosis of small-diameter vessels by using standard microsurgical technique is technically difficult and can require prolonged graft ischemia. A novel cuff system was designed from polyethylene tubing to allow anastomosis of vessels with internal luminal diameters of 0.3 to 0.9 mm. Key features include a spring-like adjustable lumen to facilitate vessel eversion, a barb to hold vessel ends in place after eversion, and a handling system that allows easy manipulation and stabilization of cuffs by a single operator. After a training period, a single operator performed a series of 8 transplants in which the mean warm ischemic time of grafts was 8.5 ± 2.9 min. Here we provide a detailed description of how to construct and perform end-to-end vessel anastomosis by using our novel cuff system. The discussion of the technique is supplemented with tips learned during the process of developing a reliable experimental model.