Cadaveric Small Bowel and Small Bowel-Liver Transplantation in Humans 1,2

Todo, Satoru; Tzakis, Andreas G.; Abu‐Elmagd, Kareem; Reyes, Jorgé; Fung, John J.; Casavilla, Adrian; Nakamura, Kenjiro; Yagihashi, Atsuhito; Jain, Ashok; Murase, Noriko; Iwaki, Yuichi; Demetris, Anthony J.; Thiel, David Van; Starzl, Thomas E.

doi:10.1097/00007890-199202010-00020

Cited by 158 publications

(58 citation statements)

References 18 publications

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“…In addition, the combination of FTY 720 and CyA almost completely abrogated the lethal GVHR in all recipients, indicating a more excellent outcome than in a previous study using highdose CyA [4]. Long-term recipient survival in rats exhibiting GVHR has been thought to result from complete suppression of alloreactive cells in the grafted organ, without any adverse reactions, such as infection due to overimmunosuppression [12,15]. From this point of view, FTY 720 may be considered a useful drug for ;…”

Section: Discussionmentioning

confidence: 91%

“…The prevention of both types of reactions is a key requirement for successful SBT [6]. SBT has recently become feasible in humans using new immunosuppressive drugs including cyclosporin A (CyA) and FK506 [3,12]. Nevertheless, it is still more difficult to control the immune reaction after SBT than after transplantation of other organs, especially in the late stages of transplantation [13, 161. FTY 720 is a chemical substance derived by modifying an immunosuppressive metabolite from Zsaria sinclairii, and its chemical structure is completely different from conventional immunosuppressants [l].…”

Section: In Trod Udionmentioning

confidence: 99%

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Prevention of graft rejection and graft-versus-host reaction by a novel immunosuppressant, FTY720, in rat small bowel transplantation

Mitsusada¹,

Suzuki²,

Kobayashi

et al. 1997

Transplant Int

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In the present study, we examined the immunosuppressive effect of a new drug, FTY 720, on small bowel transplantation (SBT) in rats. Grafts from (LEW x BN) F 1-to-LEW rats treated with FTY 720 at 0.5 mg/kg from day 0 to 14 post-SBT survived significantly longer than untreated grafts. In addition, the administration of FTY 720 combined with cyclosporin (CyA; 5 mg/kg per day) had a synergistic effect on allograft survival. The graft-versus-host reaction (GVHR) that occurred in the LEWto-F 1 rats was markedly reduced after the administration of FTY 720. FTY 720 combined with a low dose of CyA completely abrogated GVHR without any adverse reaction. FTY 720 treatment resulted in a significant decrease in the number of lymphocytes in the peripheral blood and the spleen, but the number of peripheral neutrophils was unchanged. Thus, FTY 720 would appear to be an ideal drug to combine with CyA in order to control the immune reaction after SBT.

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Section: Discussionmentioning

confidence: 91%

Section: In Trod Udionmentioning

confidence: 99%

Prevention of graft rejection and graft-versus-host reaction by a novel immunosuppressant, FTY720, in rat small bowel transplantation

Mitsusada¹,

Suzuki²,

Kobayashi

et al. 1997

Transplant Int

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“…First was the demonstration in clinical liver transplantation of the greater efficacy of tacrolimus as described in the previous section. Then, recent laboratory and clinical research with intestinal transplantation played a critical role in establishing a generic bi-directional paradigm of transplantation and immunology that is relevant to all organs.17, 24,48,59 This reassessment began after a series of human applications of the modified form of this operation, which began in 1987 when a 3-year-old girl received a multivisceral abdominal graft that contained the stomach, duodenum, pancreas, small bowel, colon, and the liver. She had an extended survival of 6 months with good intestinal graft function with-out developing either rejection or GVHD.…”

Section: Early Experimental and Clinical Studiesmentioning

confidence: 99%

Liver and Intestine Transplantation

Reyes

Todo

Starzl

1996

Immunology and Allergy Clinics of North America

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“…These are as follows: Mild to moderate acute cellular rejection is characterized by a mononuclear cell infiltrate of the mucosa associated with villus blunting, epithelial cell damage, and regeneration and a reduction in the amount of epithelial cell mucus and Paneth cells in the mucosa. Severe acute cellular rejection is characterized by mucosal hemorrhage, overt mucosal sloughing, and crypt distruction [3,10,11].…”

Section: Histologic Criteria For Intestinal Allograft Rejectionmentioning

confidence: 99%

Is rejection a diffuse or localized process in small-bowel transplantation?

et al. 1994

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Utilization of endoscopy to both visualize and selectively biopsy an intestinal allograft has become the standard for early recognition and treatment of intestinal allograft rejection. Despite the widespread acceptance of the need for selective mucosal biopsies, it has not been shown that the histological features of intestinal allograft rejection are either localized or occur as part of a more diffuse phenomenon within a tubular allograft.To resolve these issues, 88 ileoscopies were performed in 12 small-bowel allograft recipients and mucosal biopsy samples were obtained at 5, 10, and 15 cm, respectively, from the ileal stoma. Each mucosal biopsy was labeled, processed, and evaluated individually for the presence and severity of any evidence for allograft rejection.The data obtained suggest that intestinal allograft rejection is a diffuse process, and biopsies obtained randomly from an ileal graft are likely to demonstrate evidence of allograft rejection when such is present.

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Cadaveric Small Bowel and Small Bowel-Liver Transplantation in Humans 1,2

Cited by 158 publications

References 18 publications

Prevention of graft rejection and graft-versus-host reaction by a novel immunosuppressant, FTY720, in rat small bowel transplantation

Prevention of graft rejection and graft-versus-host reaction by a novel immunosuppressant, FTY720, in rat small bowel transplantation

Liver and Intestine Transplantation

Is rejection a diffuse or localized process in small-bowel transplantation?

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