Pediatric small bowel transplantation

Boluda, Esther Ramos

doi:10.1097/mot.0000000000000231

Cited by 24 publications

(18 citation statements)

References 35 publications

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“…From the beginning of ITx, it has been observed in the clinical practice that the development of ACR is associated with a progressive reduction of the intestinal motility to the point that significant ileus is observed in moderate and severe rejection, and the functional motility recovery is also a clinical indicator of recovery. 33 This observation has been also described in animal models, finding a correlation with the severity of rejection and the participation of muscle layer myeloid cells in the physiopathology of the alteration. 40 We also observed a correlation between ACR progression and loss of contractile capacity (Figure 2 ).…”

Section: Discussionmentioning

confidence: 66%

Gut Permeability and Glucose Absorption Are Affected at Early Stages of Graft Rejection in a Small Bowel Transplant Rat Model

Stringa

Romanin

Lausada

et al. 2017

Transplantation Direct

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Section: Discussionmentioning

confidence: 66%

Gut Permeability and Glucose Absorption Are Affected at Early Stages of Graft Rejection in a Small Bowel Transplant Rat Model

Stringa

Romanin

Lausada

et al. 2017

Transplantation Direct

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“…39 From the beginning of ITx, it has been observed in the clinical practice that the development of ACR is associated with a progressive reduction of the intestinal motility to the point that significant ileus is observed in moderate and severe rejection, and the functional motility recovery is also a clinical indicator of recovery. 33 This observation has been also described in animal models, finding a correlation with the severity of rejection and the participation of muscle layer myeloid cells in the physiopathology of the alteration. 40 We also observed a correlation between ACR progression and loss of contractile capacity (Figure 2).…”

Section: Figurementioning

confidence: 81%

“…31 Increase in crypt enterocyte apoptosis is 1 characteristic feature of small bowel rejection. [32][33][34] Glucose absorption takes place in villous epithelium, consequently, our observation may indicate that villous enterocytes are also affected by initial rejection events. Lymphocytes suffer from several important metabolic changes upon activation, with an increase in glycolysis being one of the most constant features.…”

Section: Figurementioning

confidence: 89%

Gut Permeability and Glucose Absorption Are Affected at Early Stages of Graft Rejection in a Small Bowel Transplant Rat Model

et al. 2017

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Background. Intestinal transplantation (ITx) faces many challenges due to the complexity of surgery and to the multiple immunological reactions that lead to the necessity of rigorous follow-up for early detection of acute cellular rejection (ACR). Our aim was to determine the kinetics of ACR using an experimental ITx model, with emphasis in the characterization of the process using different approaches, including the use of functional assays of absorptive and barrier function. Methods. ITx in rats conducting serial sampling was performed. Clinical monitoring, graft histology, proinflammatory gene expression, and nitrosative stress determination were performed. Also, glucose absorption, barrier function using ovalbumin translocation, and contractile function were analyzed. Results. The model used reproduced the different stages of ACR. Allogeneic ITx recipients showed signs of rejection from postoperative day (POD) 5, with increasing severity until 12 POD. Histological evaluation showed mild rejection in early sampling and severe rejection at late stages, with alterations in all graft layers. IL-6, CXCL 10, IFNg, and nitrite plasmas levels showed behavior coincident with histopathology. Remarkably, allogeneic grafts showed a marked alteration of glucose absorptive capacity from POD 5 that was sustained until endpoint. Coincidently, barrier function alteration was evidenced by luminal ovalbumin translocation to serum. Contractile function was progressively impaired along ACR. Conclusions. Glucose absorption and barrier function are altered at early stages of ACR when histological alterations or gene expression changes were much subtle. This observation may provide simple evaluation tools that could be eventually translated to the clinics to contribute to early ACR diagnosis.

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“…IF afflicts ten of thousands of children worldwide [ 3 ] but with an overall mortality rate of around 25%, mainly due to multi-organ system failure, sepsis, haemorrhage caused by prolonged parenteral nutrition and complications associated with intestinal transplantation [ 4 ]. IF remains the primary indication for intestinal transplantation in children, particularly related to short bowel syndrome or gastrointestinal motility disorders [ 5 ]. Unfortunately, small bowel transplantation is still a very challenging approach: in children, isolated small bowel transplantation has shown very high incidence of acute rejection, up to 45% within the first two years, with a small reduction (around 35–38%) when multi-organ transplantation is performed [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Isolation and characterisation of mouse intestinal mesoangioblasts

et al. 2018

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Aims and objectivesChildren suffering from intestinal failure (IF) endure considerable morbidity and overall have poor survival rates, complicated by the shortage of organs available for transplantation. Therefore, new therapeutic approaches are pivotal if outcomes are to be improved. Over the past years, tissue engineering (TE) has emerged as a possible alternative treatment for many congenital and acquired conditions. TE aims at creating bioengineered organs by means of combining scaffolds with appropriate cell types, which in the intestine are organised within a multilayer structure. In order to generate functional intestine, this cellular diversity and organisation will need to be recreated. While the cells for the epithelial, neural and vascular compartments have been well defined, so far, less attention has been put on the muscular compartment. More recently, mesoangioblasts (MABs) have been identified as a novel source for tissue regeneration since they are able to give rise to vascular and other mesodermal derivatives. To date MABs have not been successfully isolated from intestinal tissue. Therefore, our aim was to demonstrate the possibility of isolating MABs from adult mouse small intestine.Materials and methodsAll experiments were carried out using small intestinal tissues from C57BL/6J mice. We applied an established protocol for MAB isolation from the isolated neuromuscular layer of the small intestine. Cultured cells were stained for Ki67 to assess proliferation rates as well as for a panel of pericyte markers to determine their phenotype.ResultsCells were successfully isolated from gut biopsies. Cultured cells showed good proliferative capacity and positivity for at least three pericytes markers found in vessels of the gut neuromuscular wall: neuron-glial antigen 2, alkaline phosphatase and platelet-derived growth factor β.ConclusionThis proof-of-principle study lays the foundation for further characterization of MABs as a possible cell source for intestinal smooth muscle regeneration and TE.

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Pediatric small bowel transplantation

Cited by 24 publications

References 35 publications

Gut Permeability and Glucose Absorption Are Affected at Early Stages of Graft Rejection in a Small Bowel Transplant Rat Model

Gut Permeability and Glucose Absorption Are Affected at Early Stages of Graft Rejection in a Small Bowel Transplant Rat Model

Gut Permeability and Glucose Absorption Are Affected at Early Stages of Graft Rejection in a Small Bowel Transplant Rat Model

Isolation and characterisation of mouse intestinal mesoangioblasts

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