Beneficial effects of microsurgical lymphatic reconstruction after intestinal transplantation in rats

Kellersmann, Richard; Zhong, Robert; Gao, Z.-H; García, Bertha; Zhang, Z; Kiyochi, Hidenori; Xing, Jingjing; Grant, David

doi:10.1016/s0041-1345(98)00764-7

Cited by 4 publications

(3 citation statements)

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“…22 Recently, we and others have observed beneficial effects of LR on survival and clinical course after IT in rats. 11,12 We hypothesize that LR would ameliorate the pathophysiological changes following IT.…”

Section: Discussionmentioning

confidence: 99%

Technical experiences with a microsurgical model of lymphatic reconstruction after intestinal transplantation in rats

1999

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The surgical procedure of intestinal transplantation disrupts the graft's lymphatic drainage. Despite morphological regeneration, the functional impairment of the lymphatic system may contribute to many pathophysiological changes after transplant. We describe the technical details and results of a microsurgical model of lymphatic reconstruction (LR), which immediately reconstitutes lymphatic drainage of the intestinal graft in rats. A total of 42 orthotopic intestinal transplants with LR was performed. The patency of the LR was assessed between postoperative days 2 and 100 using either methylene-blue staining of the lymphatic vessels or mesenteric lymphoradiography. A total patency rate of 88% was achieved. Genetic background, occurrence of rejection, and immunosuppressive treatment with cyclosporine did not affect the patency rate. Technical aspects and potential applications of this model are discussed.

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Section: Discussionmentioning

confidence: 99%

Technical experiences with a microsurgical model of lymphatic reconstruction after intestinal transplantation in rats

1999

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“…It is not known whether anastomosis between donor and recipient lymphatic vessels could be beneficial for lung graft survival, but much could be learned from the surgical breakthrough that physically reconnects lymphatic vessels during intestinal transplant. Preclinical studies have demonstrated that microsurgical lymphatic reconstruction improves the long-term survival of small bowel grafts (70,71). Similar to the lung, the gastrointestinal tract is constantly challenged by a diversity of foreign antigens (72).…”

Section: Future Perspectivesmentioning

confidence: 99%

Lymphatic Vessels: The Next Frontier in Lung Transplant

et al. 2017

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Lymphatic vessels are essential for the uptake of fluid, immune cells, macromolecules, and lipids from the interstitial space. During lung transplant surgery, the pulmonary lymphatic vessel continuum is completely disrupted, and, as a result, lymphatic drainage function is severely compromised. After transplantation, the regeneration of an effective lymphatic drainage system plays a crucial role in maintaining interstitial fluid balance in the lung allograft. In the meantime, these newly formed lymphatic vessels are commonly held responsible for the development of immune responses leading to graft rejection, because they are potentially capable of transporting antigen-presenting cells loaded with allogeneic antigens to the draining lymph nodes. However, despite remarkable progress in the understanding of lymphatic biology, there is still a paucity of consistent evidence that demonstrates the exact impacts of lymphatic vessels on lung graft function. In this review, we examine the current literature related to roles of lymphatic vessels in the pathogenesis of lung transplant rejection.

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“…Thus, targeted immunosuppression regimens or an induction of immune tolerance will remain an important goal rather than the use of stronger immunosuppressive agents. Although its theoretical background is unclear, lymphatic reconstruction of rat Itx seems to have great ameliorative effect in graft survival [53,54]. There is, as yet, no clinical application of this method.…”

Section: Outcomes and Prospectsmentioning

confidence: 99%

Intestinal and Multivisceral Transplantation

et al. 2002

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Intestinal transplantation has been gradually instituted in the management of intestinal failure. More than 200 cases including isolated intestinal transplant, liver/intestinal transplant, and multivisceral transplant have been performed worldwide,with 1-year graft and patient survival rates of 66% and 54%,respectively. Indications for the procedure include short bowel syndrome and functional abnormalities secondary to a variety of diseases or conditions. Tacrolimus-based immunosuppression regimens have been used universally with improved outcomes. The major contributors to the morbidity and mortality include rejection,infection, and technical complications. Of those, control of rejection remains the most difficult dilemma and it will be the key to improved patient and graft survival.

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Beneficial effects of microsurgical lymphatic reconstruction after intestinal transplantation in rats

Cited by 4 publications

References 1 publication

Technical experiences with a microsurgical model of lymphatic reconstruction after intestinal transplantation in rats

Technical experiences with a microsurgical model of lymphatic reconstruction after intestinal transplantation in rats

Lymphatic Vessels: The Next Frontier in Lung Transplant

Intestinal and Multivisceral Transplantation

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