R. Schlemminger et al., THE ADAPTIVE RESPONSE OF THE RAT SMALL-INTESTINE AFTER RESECTION AND SEGMENTAL TRANSPLANTATION DURING THE EARLY POSTOPERATIVE PHASE, Research in experimental medicine, 193(4), 1993, pp. 213-224
Organ harvesting from a living donor or spatial constraints in the rec
ipient's abdominal cavity are the main factors to be considered in the
segmental transplantation of the small intestine. It was the aim of t
he following study to gain insight into the functional characteristics
of different portions of the small intestine either after partial res
ection or syngeneic and allogeneic transplantation during the early po
stoperative period. Nutritional parameters (serum albumin levels, seru
m triglyceride levels, maltose absorption, excretion of fecal fat) and
fat-stimulated neurotensin release were determined in Lewis rats that
underwent small bowel resection (n = 21), syngeneic (Lewis-->Lewis, n
= 21), or allogeneic transplantation (Brown Norway-->Lewis, n = 24).
The length of the remnant, isograft, or allograft was 27 cm (i.e. one
third of the rat small intestine) and consisted of the proximal (n = 7
), middle (n = 7), or distal (n = 7) portion. Three postoperative deat
hs were due to ileus or pneumonia. After allotransplantation, cyclospo
rine (15 mg/kg BW s.c.) was administered for graft acceptance. Control
s were unoperated, weight- and age-matched Lewis rats (n = 7). We foun
d that resection of two-thirds of the small intestine led to significa
ntly lower levels of albumin and triglycerides in all the three portio
ns investigated (P < 0.01) but did not affect maltose absorption. Excr
etion of fecal fat was elevated after distal resection (P < 0.05). Whe
n compared to resected animals, syngeneic transplantation did not affe
ct the nutritional parameters, but caused a significantly higher hormo
ne release (P < 0.05) in all three different intestinal grafts. Alloge
neic transplantation was successful when the middle or distal portion
was grafted. All recipients of proximal allografts showed a severe los
s of body weight and died between day 8 and 10 after transplantation.
Postmortem examination revealed no signs of acute rejection. When tran
splantation of short intestinal segments is considered, it is of vital
importance to take into account the functional differences and the in
fluence of immunosuppressive drug therapy in the regulatory bowel func
tion.