ACETAMINOPHEN ABSORPTION TEST AS A MARKER OF SMALL-BOWEL TRANSPLANT REJECTION

We recently evaluated the acetaminophen absorption test as a marker of graft rejection for small bowel transplantation(SBTX). Randomly bred male Wistar rats were used as recipients and donors. Rats (n=45) recei ved heterotopic small intestinal transplants and were divided into thr ee groups (n=15 for each group). In group A, a 10-cm segment of jejunu m of was exteriorized as a Thiry-Vella loop. In group B, immunosuppres sion was not given after SBTX In group C, rats were treated with FK506 after SBTX (0.3 mg/kg body weight, 0 similar to 6 postoperative days) . Serum acetaminophen concentrations were measured 15 min after instil lation of 0.15 g/kg acetaminophen into the intestinal loop on postoper ative days 1, 3, and 7 (n=5 for each group). Blood flow and histology of the graft were also evaluated. In the SBTX group only, the grafts s howed the histological change after acute rejection. On day 3, plasma acetaminophen concentrations in this group showed a significant decrea se, which correlated with the mild histological changes of graft rejec tion. Graft blood flow of the SBTX group decreased significantly on da y 7, following the severe graft destruction of advanced rejection. No remarkable changes were observed in the other two groups. The acetamin ophen absorption test appears to be useful for the early detection of SBTX graft rejection.