ENDOSCOPIC FINDINGS IN TRANSPLANTED ALLO-INTESTINE OF RATS AFTER DISCONTINUANCE OF IMMUNOSUPPRESSIVE AGENT

In clinical practice,graft rejection in small-bowel transplantation sh ould be diagnosed before irreversible condition of the graft. We have already re ported the usefulness of endoscopic examination for the ear ly detection of acute rejection in a rat model. Here we evaluated reje ction after discontinuance of methyl-deoxyspergualin by endoscopy. Het erotopic small-bowel transplantation was performed by the cuff method from a DA to a LEW rat. Endoscopic and histological examinations were performed through the stomas. Two-week administration of methyl-deoxys pergualin significantly prolonged graft survival. Graft rejection afte r discontinuance of the agent occurred much more slowly than rejection without the immunosuppressive drug. Erosive mucosal changes were endo scopically observed in the early phase of rejection in rats that did n ot receive the immunosuppressant. However, endoscopic findings after d iscontinuance of methyl-deoxyspergualin indicated edematous changes an d thickening of the wall without erosion, and, histologically, the gra fted intestine showed slowly-progressing rejection with flattened vill i. If we pay attention to edematous changes and hardening of intestina l wall, and take selective biopsies, endoscopic examination may improv e the early diagnosis of slowly progressive rejection in the clinical setting.