Absorption of orthotopically transplanted intestine in rats: evaluation of amino acid absorption

Advances in absorptive function of transplanted intestine

Intestinal transplantation (IT) is the only effective therapy for irreversible intestinal failure. Improvements in immunosuppression and surgical techniques have promoted the clinical use of IT, but small intestinal graft dysfunction limits the widespread use of IT. Small intestine has a crucial role in nutritive substances absorption. In order to study the effect of gastrointestinal growth factors on transplanted intestinal function, and assess digestive capabilities after IT, it is essential to investigate the intestinal recovery in structure and function after small bowel transplantation. This article summarizes the latest advances in this field, including the absorption of water, eletrolytes, carbohydrates, lipid and protein in the transplanted intestine.

Cervical heterotopic small intestinal transplantation in rats using artery sleeve anastomosis

Our goal was to establish a simple and stable cervical heterotopic small intestinal transplantation (SIT) rat model that minimizes mortality.

METHODS

The graft was removed en bloc consisting of small intestine, portal vein (PV), and donor superior mesenteric artery. The graft was perfused in situ and the gut lumen irrigated during the operation. The donor artery was end-to-end anastomosed to the recipient left common carotid artery using a sleeve technique, and the donor vein to the recipient right external jugular vein using a cuff technique. The proximal and distal ends of the graft were formed as cervical cutaneous stomas.

RESULTS

Among 106 intestinal transplantations, 40 were a formal experimental group, displaying a survival rate of 95%. Surgery lasted 70 +/- 10 minutes. The average time for the arterial anastomosis and the venous anastomosis was 5 +/- 2 minutes and 2 +/- 1 minutes, respectively. Two rats died due to late anastomotic hemorrhage or intestinal fistula; 38 survived more than 6 months.

CONCLUSION

The cervical heterotopic technique has the advantages of being easier and faster to perform with shorter cold ischemia time and higher graft survival rate as well as fewer complications.