Patent Publication Number: US-2019191692-A1

Title: Vascular anastomosis method during sustained perfusion

Description:
TECHNICAL FIELD 
     The present invention relates to a method of anastomosing a blood vessel to an organ or tissue while maintaining a perfusion state of the organ or tissue. 
     BACKGROUND ART 
     In situations such as organ transplantation and partial resection in which an organ is taken out ex vivo to resect a tumor or other sites and then returned to a living body, the organ is removed from the living body, transported, and transplanted. When such transplantation or ex vivo partial resection is performed, ischemic organs due to a blockage of the bloodstreams to the organs become a problem. 
     In other words, an interruption of the bloodstreams to organs creates a “warm ischemic” period. Warm ischemic organs cause cell swelling disorders due to depletion of ATP or cause accumulation of waste products such as hypoxanthine. The hypoxanthine accumulated in the cells is rapidly metabolized by oxygenated perfusate when the bloodstreams to the organs are resumed. During this process, a large amount of active oxygen may be generated and provoke tissue disorders. Also, substances such as cytokines secreted by the cells may evoke acute systemic shock in living bodies that the organs are put in and connected to. 
     To address this problem, for example, a method disclosed in Patent Literature 1 is proposed as a technique for preserving an organ for a long time while maintaining the function of the organ, or a technique for recovering a warm ischemic organ to a level eligible for transplantation. 
     PRIOR ART DOCUMENTS 
     Patent Literature 
     [Patent Literature 1] International Publication WO 2014/038473 
     SUMMARY OF INVENTION 
     Technical Problem 
     According to Patent Literature 1, in order to maintain or recover the function of an organ, the organ is connected to a perfusion circuit and supplied with perfusate to maintain or recover the function of the organ. 
     In this case, the organ removed from a donor is put in a recipient&#39;s body and connected to the perfusion circuit to continue perfusion of the organ until just before the start of anastomosis of lumens such as blood vessels. However, the organ is disconnected from the perfusion circuit and falls into a warm ischemic state at the time when the anastomosis of lumens is started. Therefore, the longer it takes to resume the bloodstreams to the organ after the organ has been put in the recipient, the greater the adverse effects of the warm ischemic state of the organ on the recipient. 
     In view of this, it is an object of the present invention to provide a perfusion method in which the influence of the warm ischemic state of an organ is reduced by extending a period of maintaining perfusion of the organ from when the organ has been put in a recipient to when the bloodstreams to the organ is resumed, and to provide a lumen connection method using the perfusion method. 
     Solution to Problem 
     To solve the above-described problems, the present invention describes a perfusion method of perfusing an organ or tissue from which at least one artery and at least one vein protrude. The method includes a) a supply duct connecting step of incising or dissecting at least one of the artery and connecting thereto a supply duct for supplying perfusate to the organ or tissue, b) a discharge duct connecting step of incising or dissecting at least one of the vein and connecting thereto a discharge duct for discharging perfusate draining from the organ or tissue, and c) a perfusion step of allowing perfusate to enter from the supply duct, to pass through the organ or tissue, and to be discharged through the discharge duct. In the steps a) and b), the blood vessel and the supply duct or the discharge duct are bound at a position away from the incised or dissected site toward a proximal side viewed from the organ or tissue. 
     To solve the above-described problems, the present invention describes a vascular anastomosis method for anastomosis to a blood vessel of a living body while maintaining a perfusion state of an organ or tissue from which at least one artery and at least one vein protrude. The method includes a) a supply duct connecting step of incising or dissecting at least one of the artery and connecting thereto a supply duct for supplying perfusate to the organ or tissue, b) a discharge duct connecting step of incising or dissecting at least one of the vein and connecting thereto a discharge duct for discharging perfusate draining from the organ or tissue, c) a perfusion step of allowing perfusate to enter from the supply duct, to pass through the organ or tissue, and to be discharged through the discharge duct, and d) an anastomosis step of anastomosing the artery and the vein to blood vessels of a living body while maintaining the perfusion state of the organ or tissue in the step c). In the steps a) and b), the blood vessel and the supply duct or the discharge duct are bound at a position away from the incised or dissected site toward a proximal side viewed from the organ or tissue. 
     The step d) includes d1) a threading step of threading a suture between the artery or the vein and a blood vessel of the living body while avoiding the supply duct or the discharge duct connected to the artery or the vein, d2) a perfusion stopping step of stopping perfusion of the organ or tissue and extracting the supply duct and the discharge duct from the artery and the vein, and d3) a suture step of pulling the suture threaded between the artery or the vein and the blood vessel of the living body to suture the artery or the vein and the blood vessel of the living body. 
     To solve the above-described problems, the present invention describes a perfusion method of perfusing an organ or tissue from which at least one vein and at least one artery protrude. The method includes p) a supply duct connecting step of incising or dissecting at least one of the vein and connecting thereto a supply duct for supplying perfusate to the organ or tissue, q) a discharge duct connecting step of incising or dissecting at least one of the artery and connecting thereto a discharge duct for discharging perfusate draining from the organ or tissue, and r) a perfusion step of allowing perfusate to enter from the supply duct, to pass through the organ or tissue, and to be discharged through the discharge duct. In the steps p) and q), the blood vessel and the supply duct or the discharge duct are bound at a position away from the incised or dissected site toward a proximal side viewed from the organ or tissue. 
     To solve the above-described problems, the present invention describes a vascular anastomosis method for anastomosis to a blood vessel of a living body while maintaining a perfusion state of an organ or tissue from which at least one vein and at least one artery protrude. The method includes p) a supply duct connecting step of incising or dissecting at least one of the vein and connecting thereto a supply duct for supplying perfusate to the organ or tissue, q) a discharge duct connecting step of incising or dissecting at least one of the artery and connecting thereto a discharge duct for discharging perfusate draining from the organ or tissue, r) a perfusion step of allowing perfusate to enter from the supply duct, to pass through the organ or tissue, and to be discharged through the discharge duct, and s) an anastomosis step of anastomosing the vein and the artery to blood vessels of a living body while maintaining the perfusion state of the organ or tissue in the step r). In the steps p) and q), the blood vessel and the supply duct or the discharge duct are bound at a position away from the incised or dissected site toward a proximal side viewed from the organ or tissue. 
     The step s) includes s1) a threading step of threading a suture between the vein or the artery and a blood vessel of the living body while avoiding the supply duct or the discharge duct connected to the vein or the artery, s2) a perfusion stopping step of stopping perfusion of the organ or tissue and extracting the supply duct and the discharge duct from the vein and the artery, and s3) a suture step of pulling the suture threaded between the vein or the artery and the blood vessel of the living body to suture the vein or the artery and the blood vessel of the living body. 
     Note that the scope of the present invention also includes an invention for which one or more features of the present invention listed above are freely combined. 
     Effects of the Invention 
     According to the invention, the ducts for supplying and discharging perfusate are secured to the blood vessels protruding from the organ or tissue, at the positions away from the cut ends of the blood vessels. This enables threading the blood vessels together with a suture while avoiding the ducts for supplying and discharging perfusate to and from the organ or tissue. The blood vessels can be sutured by extracting the ducts, with the suture threaded around the blood vessels in advance, and then pulling the suture rapidly. This reduces the influence of the warm ischemic state of the organ or tissue after the organ or tissue has been put in a living body. 
    
    
     
       BRIEF DESCRIPTION OF DRAWINGS 
         FIG. 1  illustrates how donor&#39;s renal artery and renal vein are treated according to the present invention; 
         FIG. 2  is an enlarged view illustrating how the tip end of the donor&#39;s renal artery is treated according to the present invention; 
         FIG. 3  shows the condition after the treatments of a donor&#39;s kidney are completed according to the present invention; 
         FIG. 4  is a schematic diagram of a perfusion device according to the present invention; 
         FIG. 5  illustrates how the donor&#39;s kidney is anastomosed to recipient&#39;s blood vessels according to the present invention; 
         FIG. 6  shows the condition after the anastomosis of the donor&#39;s kidney to the recipient&#39;s blood vessels is completed according to the present invention; and 
         FIG. 7  illustrates how the anastomotic site is tightened according to the present invention. 
     
    
    
     DESCRIPTION OF EMBODIMENTS 
     As one embodiment of the present invention, kidney transplantation is described as an example. Note that the procedure described below is also applicable to partial resection in which an organ is temporarily removed from a living body to resect a lesion such as a tumor ex vivo from the organ and then returned to the original living body. 
     In the present application, donors and recipients may be humans, or may be non-human animals. The non-human animals may be rodents such as mice and rats; ungulates such as pigs (including miniature swine), goats, and sheep; carnivores including dogs; non-human primates such as monkeys, baboons, and chimpanzees; and other non-human mammals such as rabbits. The non-human animals may also be non-mammalian animals. 
     First, a kidney graft is removed from a donor, and perfusion cannulas are inserted in the kidney graft. The removal may be conducted in the following procedure of steps (D-1) to (D-5). Although the following description is given on the treatment for the right kidney, the similar treatments may also be given to the left kidney. 
     (D-1) 
     A renal artery  11 , a renal vein  13 , and an ureter  15  that are the lumens connected to a kidney  10  are sectioned to remove the kidney  10  from a donor (see  FIG. 1 ). 
     (D-2) 
       FIG. 1  illustrates how donor&#39;s renal artery  11  and renal vein  13  are treated in step (D-2).  FIG. 2  is an enlarged view illustrating how the tip end of the donor&#39;s renal artery  11  is treated in step (D-2). As illustrated in  FIG. 1 , perfusion cannulas are connected to the removed donor&#39;s kidney  10 . Specifically, a perfusate inflow cannula  21  is connected to the renal artery  11 , and a perfusate outflow cannula  23  is connected to the renal vein  13 . 
     When each cannula is connected, the blood vessel is ligated as illustrated in  FIG. 2 . In other words, after the cannula (perfusate inflow cannula  21  in  FIG. 2 ) has been inserted in the blood vessel (renal artery  11  in  FIG. 2 ), the blood vessel is ligated with a suture (suture  41  in  FIG. 2 ) at a side proximal to the vicinity of the cut end of the blood vessel, viewed from the kidney. At this time, the blood vessel is ligated at such a position that, after the ligation, the width of the cut end of the blood vessel can be extended with tweezers or other instruments to twice or more of the outside diameter of the cannula inserted in the blood vessel. For example, the blood vessel is ligated at a position 5 mm or more away from the cut end of the blood vessel. When the blood vessel is an artery, the side of the blood vessel that is distal to the aforementioned ligated position, viewed from the kidney, is referred to as an anastomotic end region  31 . When the blood vessel is a vein, the side of the blood vessel that is distal to the aforementioned ligated position, viewed from the kidney, is referred to as an anastomotic end region  33 . 
     As described above, the renal artery  11  and the perfusate inflow cannula  21  are ligated and secured with the suture  41  at the position away from the cut end of the blood vessel. Also, the renal vein  13  and the perfusate outflow cannula  23  are ligated and secured with a suture  43  at the position away from the cut end of the blood vessel. Accordingly, when each blood vessel is anastomosed to a recipient&#39;s blood vessel described later, it is easy to thread the two blood vessels together with a suture while moving the cannulas connected to each blood vessel in various directions. This enables rapid anastomosis to the recipient&#39;s blood vessel while maintaining the perfusion state of the kidney  10 . 
     The present embodiment describes an example in which the blood vessel is ligated with the suture  41 . Alternatively, the method used to secure the cannula to the blood vessel may be other methods such as a method of pressing the blood vessel with a material such as a removable belt or an extendable band to bind the blood vessel with the cannula. 
     As described above, in the case of anastomosis to recipient&#39;s blood vessel, cannulas are moved in various directions during suture. Therefore, the perfusion of the kidney  10  is preferably maintained even if the renal artery  11  and the perfusate inflow cannula  21 , or the renal vein  13  and the perfusate outflow cannula  23 , are not arranged in a straight line (i.e., they bend at the positions ligated with the sutures  41  and  43 ). For this reason, for example, each cannula preferably has characteristics such that it has flexibility at least on the side proximal to the ligated position (on the side of tip end of the cannula), viewed from the kidney  10 , or that its portion on the side proximal to the ligated position, viewed from the kidney  10 , has a length approximately equal to or shorter than the diameter of the tip end of the cannula. The cannula also desirably has a tip end with rounded corners or has a round-shaped tip end, in order not to damage the inner wall of the blood vessel. 
       FIG. 3  illustrates the condition after the connection of the perfusate inflow cannula  21  and the perfusate outflow cannula  23  to the kidney  10  is completed and, in particular, illustrates the vicinity of the renal vein  13  in enlarge dimension. The renal vein  13  is ligated with the suture  43  for securing the perfusate outflow cannula  23 , at the position away from the cut end of the renal vein  13  toward the proximal side viewed from the kidney  10 . Thus, when the cut end of the renal vein  13  is extended with tweezers as illustrated in  FIG. 3 , the width of the opening at the cut end can be extended to twice or more of the outside diameter of the inserted perfusate outflow cannula  23 . 
     As described above, steps (D-1) and (D-2) include a supply duct connecting step of, to perfuse a kidney that is an organ or tissue from which at least one artery and at least one vein protrude, incising or dissecting at least one (renal artery  11 ) of the artery and connecting thereto a supply duct (perfusate inflow cannula  21 ) for supplying perfusate to the kidney. Steps (D-1) and (D-2) also include a discharge duct connecting step of incising or dissecting at least one (renal vein  13 ) of the vein and connecting thereto a discharge duct (perfusate outflow cannula  23 ) for discharging perfusate draining from the kidney. In the supply duct connecting step and the discharge duct connecting step, the blood vessel and the supply duct or the discharge duct are bound at a position away from the incised or dissected site toward the proximal side viewed from the kidney. 
     (D-3) 
     The cannulas connected to the donor&#39;s kidney in the above described procedure of steps (D-1) and (D-2) are each connected to a perfusion device described later to start perfusion. In other words, perfusate is allowed to enter from the perfusate inflow cannula  21  and to drain from the perfusate outflow cannula  23 . 
     Step (D-3) is a perfusion step of allowing perfusate to enter from the supply duct (perfusate inflow cannula  21 ), to pass through the kidney, and to be discharged through the discharge duct (perfusate outflow cannula  23 ). 
     In steps (D-1) to (D-3) described above, treatments that are normally given in the procedure for removing a kidney graft from a donor (e.g., excision of connective tissues, peeling of blood vessels, temporary ligation or clamping of blood vessels for section of the blood vessels, blockage and dissection of the ureter, application of coagulation agents to the kidney graft, hemostasis at operation sites) may be given as needed by those skilled in the art. 
       FIG. 4  illustrates one example of the perfusion device used in the present embodiment. A perfusion device  100  includes a reactor  101  that keeps the kidney  10 , an inflow pathway  103  for supplying perfusate to the perfusate inflow cannula  21  connected to the renal artery  11 , an outflow pathway  107  for collecting perfusate from the perfusate outflow cannula  23  connected to the renal vein  13 , and a reservoir  109  that stores perfusate. 
     A pump  111  that conveys perfusate under pressure, a deaerator  113  that deaerates perfusate, and a thermo-regulator  115  that regulates the temperature of perfusate are interposed in the inflow pathway  103 . 
     A pump  131  that collects perfusate from the kidney  10 , and a gas supply module  133  that adds oxygen and carbon dioxide to perfusate are interposed in the outflow pathway  107 . The gas supply module  133  is connected to an oxygen supply part  135  and a carbon dioxide supply part  137 . 
     In the present invention, in addition to oxygen and carbon dioxide, nitrogen may be further added to perfusate. In this case, the gas supply module  133  is connected to a nitrogen supply part for supplying nitrogen. 
     The kidney  10  removed from the donor in the above-described procedure of steps (D-1) to (D-3) is connected to the perfusion device  100 , kept in the reactor  101 , and preserved by perfusion. Although the perfusion process according to the present embodiment is performed by circulating perfusate between the donor&#39;s kidney  10  and the perfusion device  100 , the perfusion process that is performed on the donor&#39;s kidney  10  is not limited to this embodiment. In other words, other configurations may be employed, such as a configuration in which perfusate that has passed through the donor&#39;s kidney  10  is collected in a container other than the reservoir  109  or in which perfusate is disposed of directly. Alternatively, a system of conveying perfusate by gravity to the donor&#39;s kidney  10 , such as a drip infusion bag, may be employed instead of the configuration of conveying perfusate under pressure with a pump as in the above-described embodiment. 
     Next, the donor&#39;s kidney  10  is put in the recipient. Then, vascular anastomosis is conducted in the following procedure. 
     (A-1) 
       FIG. 5  illustrates how the donor&#39;s kidney is anastomosed to the recipient&#39;s blood vessels in steps (A-1) to (A-3). Hereinafter, the right side of the page in  FIG. 5  is referred to as “one side,” and the left side of the page as the “other side.” First, as illustrated in  FIG. 5 , part of the vascular wall of an abdominal aorta  101  is pinched with vessel forceps  103  such as Satinsky forceps (side clamping) to isolate that part from the bloodstream in the blood vessel, and the vascular wall pinched with the vessel forceps  103  is incised. Similarly, part of the vascular wall of an inferior vena cava  111  is pinched with vessel forceps  113  such as Satinsky forceps (side clamping) to isolate that part from the bloodstream in the blood vessel, and the vascular wall pinched with the vessel forceps  113  is incised. 
     (A-2) 
     Next, the renal artery  11  of the donor&#39;s kidney and the recipient&#39;s abdominal aorta  101  are joined by end-to-side anastomosis. A doubly armed suture  105  is threaded with the vicinity of the cut end of the renal artery  11  on the side on which the perfusate inflow cannula  21  is placed after the anastomosis (on one side). In addition, another doubly armed suture is threaded with the opposite side of the cut end of the renal artery  11  (on the other side). Thereafter, the other side of the renal artery  11  and the vascular wall of the abdominal aorta  101  pinched with the vessel forceps  103  are continuously sutured with the doubly armed suture threaded on the other side. Subsequently, the one side of the renal artery  11  and the abdominal aorta  101 , i.e., the vascular wall of the abdominal aorta  101  pinched with the vessel forceps  103 , are also continuously sutured. Note that, in the case of suturing on the one side, the suture is threaded between the renal artery  11  and the abdominal aorta  101  while avoiding the perfusate inflow cannula  21  in the vicinity of the perfusate inflow cannula  21 . Then, the doubly armed suture  105  is pinched with forceps  107  such as Pean&#39;s forceps and left in place at the site of operation without being tighten until the perfusate inflow cannula  21  is extracted. 
     (A-3) 
     Next, the renal vein  13  of the donor&#39;s kidney and the recipient&#39;s inferior vena cava  111  are joined by end-to-side anastomosis. A doubly armed suture  115  is threaded with the vicinity of the cut end of the renal vein  13  on the side on which the perfusate outflow cannula  23  is placed after the anastomosis (on one side). In addition, another doubly armed suture is threaded with the opposite side of the cut end of the renal vein  13  (on the other side). Thereafter, the other side of the renal vein  13  and the vascular wall of the inferior vena cava  111  pinched with the vessel forceps  113  are continuously sutured with the doubly armed suture threaded on the other side. Subsequently, the one side of the renal vein  13  and the inferior vena cava  111 , i.e., the vascular wall of the inferior vena cava  111  pinched with the vessel forceps  113 , are also continuously sutured. Note that, in the case of suturing on the one side, the suture is threaded between the renal vein  13  and the inferior vena cava  111  while avoiding the perfusate outflow cannula  23  in the vicinity of the perfusate outflow cannula  23 . Then, the doubly armed suture  115  is pinched with forceps  117  such as Pean&#39;s forceps and left in place at the site of operation without being tighten until the perfusate outflow cannula  23  is extracted. 
     Even during the anastomosis of the blood vessels in the above-described procedure of steps (A-2) and (A-3), the perfusate continues to circulate from the perfusate inflow cannula  21  through the donor&#39;s kidney  10  to the perfusate outflow cannula  23 . Thus, the perfusion state of the donor&#39;s kidney  10  is maintained. 
       FIG. 6  illustrates the condition after the end-to-side anastomosis of the renal artery  11  to the abdominal aorta  101  and the end-to-side anastomosis of the renal vein  13  to the inferior vena cava  111  are completed in the above-described procedure of steps (A-1) to (A-3). In particular,  FIG. 6  illustrates the condition in which the doubly armed suture  115  is threaded with the renal vein  13  with the perfusate outflow cannula  23  left in place, and the doubly armed suture  115  is left loose until the perfusate outflow cannula  23  is extracted. 
     (A-4) 
     Then, the perfusate inflow cannula  21  is extracted. Specifically, the suture  41  is cut, and the perfusate inflow cannula  21  is extracted. Then, the doubly armed suture  105  pinched with forceps  107  is pulled in a distal direction viewed from the kidney  10  so as to ligate the renal artery  11  and the abdominal aorta  101  while keeping them in intimate contact with each other. Subsequently, the vessel forceps  103  pinching the vascular wall of the abdominal aorta  101  is removed to resume the bloodstream to the kidney  10 , and the suture site or other sites are checked for bleeding. In the case of bleeding, additional treatments such as suturing are given. 
     (A-5) 
     Then, the perfusate outflow cannula  23  is extracted. Specifically, the suture  43  is cut, and the perfusate outflow cannula  23  is extracted. Thereafter, drainage of the recipient&#39;s blood from the renal vein is awaited. When the drainage of the recipient&#39;s blood is confirmed, the doubly armed suture  115  pinched with the forceps  117  is pulled in a distal direction viewed from the kidney  10  so as to ligate the renal vein  13  and the inferior vena cava  111  while keeping them in intimate contact with each other. Then, the vessel forceps  113  pinching the vascular wall of the inferior vena cava  111  are removed to resume the bloodstream from the kidney  10  to the inferior vena cava  111 , and the suture site or other sites are checked for bleeding. In the case of bleeding, additional treatments such as suturing are given. 
       FIG. 7  illustrates the condition that the perfusate outflow cannula  23  has been extracted, and the suture site of the renal vein  13  and the inferior vena cava  111  is being tightened by pulling the doubly armed suture  115 . Here, the suture site is tightened by pulling the doubly armed suture  115  with the forceps  117  in a direction away from the kidney  10  (in the right oblique downward direction in  FIG. 7 ). 
     As described above, steps (A-1) to (A-5) include an anastomosis step of anastomosing an artery (renal artery  11 ) and a vein (renal vein  13 ) to blood vessels of a living body (recipient) while maintaining the perfusion state of the kidney in the perfusion step started in step (D-3). 
     More specifically, steps (A-2) and (A-3) include a threading step of threading a suture between the artery (renal artery  11 ) or the vein (renal vein  13 ) and a blood vessel of the living body (recipient) while avoiding the supply duct (perfusate inflow cannula  21 ) or the discharge duct (perfusate outflow cannula  23 ) connected to the artery (renal artery  11 ) or the vein (renal vein  13 ). 
     Steps (A-4) and (A-5) include a perfusion stopping step of stopping the perfusion of the kidney and extracting the supply duct (perfusate inflow cannula  21 ) and the discharge duct (perfusate outflow cannula  23 ) from the artery (renal artery  11 ) and the vein (renal vein  13 ). Steps (A-4) and (A-5) also include a suture step of pulling the suture threaded between the artery (renal artery  11 ) or the vein (renal vein  13 ) and the blood vessel of the living body (recipient) to suture the artery (renal artery  11 ) or the vein (renal vein  13 ) and the blood vessel of the living body (recipient). 
     (A-6) 
     Finally, the ureter  15  of the donor&#39;s kidney  10  is joined to the recipient&#39;s bladder by end-to-side anastomosis. 
     In the above-described procedure, the recipient&#39;s blood vessels that are anastomosed to the blood vessels of the donor&#39;s kidney may be the same type of blood vessels as the donor&#39;s blood vessels used for anastomosis, or may be a different type of blood vessels therefrom. In the case of kidney orthotopic transplantation, for example, the recipient&#39;s blood vessels that are anastomosed to the blood vessels of the donor&#39;s kidney may be the same type of blood vessels as the blood vessels of the donor&#39;s kidney used for anastomosis. In the case of kidney heterotopic transplantation, for example, the recipient&#39;s blood vessels that are anastomosed to the blood vessels of the donor&#39;s kidney may be a different type of blood vessels from the blood vessels of the donor&#39;s kidney used for anastomosis. The type of recipient&#39;s blood vessels used in kidney heterotopic transplantation can be appropriately selected on the basis of common general technical knowledge by those skilled in the art. 
     In the above-described procedure, treatments that are normally given in the procedure for transplanting a kidney graft into a recipient (e.g., excision of connective tissues, peeling of blood vessels, temporary ligation or clamping of blood vessels for section and anastomose of the blood vessels, anastomosis of blood vessels, hemostasis at operation sites) may be given as needed by those skilled in the art. 
     While the above-described embodiment employs a kidney as a target organ, the target of the present invention is not limited to the kidney. In other words, the “organ or tissue” according to the present invention is not particularly limited as long as it can be perfused. Examples of the target organ include hearts, livers, kidneys, lungs, pancreases, stomachs, small intestines, large intestines, testes, ovaries, eyeballs, teeth and their surrounding tissues, and hairs and their surrounding tissues. 
     In the above-described embodiment, the perfusion of an organ involves supplying perfusate to an artery and discharging the perfusate from a vein. However, the target of the present invention is not limited to this. In other words, the perfusion of an organ also includes a configuration of supplying perfusate to the vein side and discharging the perfusate from the artery side, as in Langendorff perfusion of hearts. 
     The shapes, structures, sizes and materials of cannulas and tubes used in the present invention are not limited, and can be appropriately selected depending on the type of blood vessel by those skilled in the art. 
     The composition of the perfusate used in the perfusion device of the present invention is not limited as long as it is used in the perfusion of a normal kidney graft, and commercially available perfusate (e.g., L-15 medium) may be used. Note that the perfusate is preferably supplemented with an oxygen carrier. Containing an oxygen carrier in the perfusate can suppress disorders of the kidney graft and can increase the success rate of kidney transplantation. Examples of the oxygen carrier used in the present invention include erythrocytes and artificial erythrocytes. Erythrocytes supplemented to the perfusate of the present invention are preferably erythrocytes of the blood type available for blood transfusion for the donor or the recipient, and more preferably erythrocytes derived from the donor or the recipient. Also, artificial erythrocytes supplemented to the perfusate of the present invention need only be molecules having a function of transporting oxygen, and examples thereof include perfluorocarbon and hemoglobin vesicles. 
     In the present invention, the “kidney graft” is not limited to the kidney removed from the donor. For example, the kidney graft may be an artificial kidney derived from stem cells such as iPS cells. 
     The terms as used in the specification of the present invention, unless otherwise defined particularly, are used to describe specific embodiments and do not intend to limit the invention. 
     Also, the term “including” as used in the specification of the present invention, unless otherwise clearly required to be understood differently by the content, intends to mean the presence of described items (such as components, steps, elements, and numbers), and does not intend to exclude the presence of other items (such as components, steps, elements, and numbers). 
     Unless otherwise defined, all the terms as used herein (including technical and scientific terms) have the same meanings as those broadly recognized by those skilled in the art of the technology to which the present invention pertains. The terms as used herein, unless otherwise explicitly defined, are to be construed as having meanings consistent with those in the specification of the present invention and in related technical fields, and shall not be construed as being idealized or as being interpreted as excessively formal meanings. 
     REFERENCE SIGNS LIST 
     
         
         
           
               10  Kidney 
               11  Renal artery 
               13  Renal vein 
               15  Ureter 
               21  Perfusate inflow cannula 
               23  Perfusate outflow cannula 
               31  Anastomotic end region 
               33  Anastomotic end region 
               41  Suture 
               43  Suture 
               100  Perfusion device 
               101  Reactor 
               101  Abdominal aorta 
               103  Inflow pathway 
               103  Vessel forceps 
               105  Doubly armed suture 
               107  Outflow pathway 
               107  Forceps 
               109  Reservoir 
               111  Pump 
               111  Inferior vena cava 
               113  Deaerator 
               113  Vessel forceps 
               115  Thermo-regulator 
               115  Doubly armed suture 
               117  Forceps 
               131  Pump 
               133  Gas supply module 
               135  Oxygen supply part 
               137  Carbon dioxide supply part