EXPERIMENTAL SMALL BOWEL TRANSPLANTATIONUTILIZING Cyclosporine

Didlake, Ralph; Cayirli, Mukadder; Turner, M. Don; Grogan, James B.; Achord, James L.

doi:10.1097/00007890-198412000-00001

Cited by 19 publications

(2 citation statements)

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“…Further additional strategies should be developed to provide a rapid and accurate diagnosis of graft rejection. Monitoring the motility pattern is thought to be a useful and minimally invasive method to identify indicators of intestinal rejection in the long‐term (8), but no clinical and few experimental data on in vivo motility patterns are available.…”

Section: Introductionmentioning

confidence: 99%

Correlation of Motility and Neuronal Integrity with a Focus on the Grade of Intestinal Allograft Rejection

Watanabe

Hoshino

Tanabe

et al. 2008

American Journal of Transplantation

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Intestinal graft motility after small bowel transplantation (SBT) is poorly characterized. The aim of this study was to compare motor patterns with myenteric neuronal cell population as a parameter of graft viability at various degrees of acute cellular rejection (ACR). Three grades of ACR were achieved in orthotopic allografts. Syngeneic transplants and allografts with immunosuppression served as controls. Motor activities were recorded using strain gauge force transducers and analyzed visually. Quantifications of myenteric neurons in whole mounts of intestinal grafts were used to evaluate neuronal population. A typical migrating motor complex (MMC) was found in syngeneic and allogenic transplants with immunosuppression. A high prevalence of discrete clustered contractions (DCC) and nonpropagating contractions (NPC) without MMC was seen in moderately and severely rejected allografts. Neuronal cell loss in the allografts, which could be one of the causes of motor dysfunction, was noted in moderate rejection (19.3%) and progressed until severe rejection (60.1%). Monitoring motility patterns in SBT could be an effective tool for assessing intestinal rejection. Allograft dysmotility, such as absence of MMC and high prevalence of DCC or NPC, could be useful markers of progression of acute rejection and help guide treatment decisions.

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Section: Introductionmentioning

confidence: 99%

Correlation of Motility and Neuronal Integrity with a Focus on the Grade of Intestinal Allograft Rejection

Watanabe

Hoshino

Tanabe

et al. 2008

American Journal of Transplantation

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“…The majority of animais that succumbed despite treatment developed voluminous diarrhea, malnutrition, and infection, presumably a consequence of acute graft rejection. Finally, Raju and associates reiterated that steroid therapy adds little to the immunosuppression provided by CyS for small intestinal transplant segments [15]. In an ectopic dog model, these researchers found that the addition of prednisone to a standard daily regimen of cyclosporine improved survival from 56 to 60 days, neither a statistically nor clinically significant effect, despite an apparent improvement in the histological features of the grafts.…”

Section: Prevention Of Rejectionmentioning

confidence: 99%

Small bowel transplantation

Pritchard

Kirkman

1985

World j. surg.

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Small bowel transplantation may offer a future alternative to patients with short bowel syndrome. However, currently available immunosuppressive regimens are not adequate to prevent rejection of small bowel allografts. Recent experimental studies using cyclosporine have provided improved results, especially in rats; but there are relatively few long‐term survivors in large animal models. Graft‐versushost disease may result from lymphoid tissue in the small bowel transplant but is less troublesome than rejection. Seven patients have undergone small bowel transplantation; the longest survivor died at 6 months. Clinical application of small bowel transplantation must await further refinements in immunosuppression.

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