SEGMENTAL INTESTINAL TRANSPLANTATION CAN BE AN ADEQUATE THERAPY FOR SHORT-BOWEL SYNDROME IN GROWING DOGS

This study was undertaken to investigate whether two stage segmental s mall bowel allotransplantation can maintain growth and development of young dogs (16 weeks, 5 to 6kg) with surgically created short bowel sy ndrome (SBS). After near-total small bowel resection (group 1; n = 3), irreversible weight loss was noted. After a sham operation (group 2; n = 3), no growth disturbances were found. Major histocompatibility ma tched small bowel transplantation (SET) with cyclosporine A as immunos uppressant, was performed in two stages (group 3; n = 7). During the f irst stage, one meter of jejunoileum from an adult donor was placed as a Roux loop. Four weeks later, the native small bowel was removed and replaced by the graft. Only one dog survived long-term; the dogs died from infectious complications. The addition of selective decontaminat ion of the digestive tract and early gastrostomy feeding (group 4; n = 10) resulted in long term survival in 60%. Follow-up at 4 months show ed that their growth was about 20% compromised compared with that of t he sham-operated animals. Functional analysis showed that electrolytes , urea, and D-xylose were normal, but there was an increase in the lac tulose:mannitol ratio, fecal fat excretion, and postheparin diamine ox idase release. These results show that under the conditions described, segmental SET functions sufficiently to treat SBS but does not mainta in normal growth. Copyright (C) 1995 by W.B. Saunders Company