# Refined cuff technique minimizes surgical complexity in rat lung transplantation and improves outcomes

## TL;DR

A refined surgical technique for rat lung transplants reduces complexity and improves long-term outcomes, making it easier to study chronic lung graft issues.

## Contribution

A novel surgical model with intraoperative modifications and ventilation strategies that simplifies rat lung transplantation and improves reproducibility.

## Key findings

- The refined technique achieved high procedural success and reproducible long-term survival in rat lung transplants.
- Histopathological analysis showed chronic remodeling and reduced acute rejection with the new method.
- The technique uses accessible clinical-grade materials and has a short learning curve.

## Abstract

Orthotopic lung transplantation in rats serves as a pivotal platform for exploring long-term allograft outcomes, yet technical complexity has limited its widespread application. Here, we present a refined surgical model that combines structured intraoperative modifications with tailored mechanical ventilation strategies to ensure procedural consistency and biologic fidelity. Key interventions—such as a custom leak-proof endotracheal tube, a temporally controlled reperfusion maneuver, and an optimized anastomotic sequence—collectively addressed critical challenges including airway obstruction, graft impaired perfusion, and venous fragility. The protocol demonstrated a high procedural success rate and reproducible long-term survival, with histopathological analysis confirming progressive chronic remodeling and diminished acute rejection. Importantly, the technique demonstrated features that facilitate rapid acquisition, supported by a short learning curve, and was implemented using widely accessible clinical-grade materials. Together, these attributes establish a robust and scalable platform for investigating chronic lung allograft dysfunction and other long-term immunologic phenomena.

The online version contains supplementary material available at 10.1038/s41598-025-19711-2.