Graft versus host disease in small bowel transplantation

Abstract

Quantities of organized lymphoid tissue in small bowel allografts may cause graft versus host disease (GVHD) following transplantation. This study examines the effect of graft mesenteric lymphadenectomy on development of GVHD following small bowel transplantation in rats. GVH reactivity was assessed by measuring the degree of graft cell emigration to the host. In the PVG to DA strain combination, graft mesenteric lymphadenectomy led to a significant reduction in graft cell colonization of host lymphoid tissues from 40-50 per cent to 25-35 per cent. Transplantation from PVG to (PVG x DA)F1 hybrids caused fatal GVHD within 21 days whereas when DA donors were used survival was over 30 days. When mesenteric lymphadenectomy was performed on PVG donors, host survival increased by only 3-4 days. Mesenteric lymphadenectomy in DA donors led to long-term recipient survival with no GVHD. Intensity of GVHD following rat small bowel transplantation is a strain-dependent phenomenon and graft mesenteric lymphadenectomy does not always prevent GVHD. The mucosa may have an important immunological role.

Graft-versus-Host Reaction in Small-Bowel Transplantation and Possibilities for Its Circumvention

“…This result is consistent with a previous report that graft mesenteric lymphadenectomy prevented GVHR only in certain strain combinations. 9 The present results suggest that the intestinal mucosal layer has an important immunological role in small-bowel transplantation-induced GVHR. Indeed, it has already been reported that small-bowel-transplantation-induced GVHR depends on the length and site of origin.…”

Pathology of Pediatric Gastrointestinal and Liver Disease

“…The time to development of chronic rejection is variable and has ranged from as little as 2 months to years posttransplant. recipient s peripheral blood and bone marrow (Clark et al 1991 ;Morrissey et al 1999 ;Shin et al 2011 ;Andres et al 2010 ). Clinically, it is characterized by persistent diarrhea with bleeding and increased stomal output.…”

Early Detection of Apoptosis and Fas Ligand Expression in Hepatic Graft-versus-Host Disease after Rat Small Bowel Transplantation

“…GVHD after intestinal transplantation is reported to be caused by the large number of cytotoxic T cells (CTLs) contained in the graft gut-associated lymphoid tissue (GALT) [1]. GALT, including intraepithelial T lymphocytes (IELs), is a phenotypically unique population among peripheral T cells, consisting of a large percentage of ␥␦ T cells [2], which have recently been reported to induce GVHD in such target organs as the liver [3].…”