Intestinal transplantation

Loo, Larry; Vrakas, G.; Reddy, Srikanth; Allan, Philip

doi:10.1097/mog.0000000000000358

Cited by 28 publications

(21 citation statements)

References 88 publications

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“… 31 Increase in crypt enterocyte apoptosis is 1 characteristic feature of small bowel rejection. 32 - 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: Discussionmentioning

confidence: 69%

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: 69%

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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show abstract

“…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: 88%

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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“…The biggest problem in intestinal transplantation is graft rejection, and it is the main reason for morbidity and mortality. The diagnosis of rejection is confirmed by clinical symptoms, endoscopic appearance, and pathological specimens taken by endoscopy [94].…”

Section: Intestine Transplant Recipientsmentioning

confidence: 91%

Anesthetic Considerations in Transplant Recipients for Nontransplant Surgery

Brusich¹,

Acan²

2018

Organ Donation and Transplantation - Current Status and Future Challenges

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As solid organ transplantation increases and patient survival improves, it will become more common for these patients to present for nontransplant surgery. Recipients may present with medical problems unique to the transplant, and important considerations are necessary to keep the transplanted organ functioning. A comprehensive preoperative examination with specific focus on graft functioning is required. The anesthesiologist needs to pay close attention to considerations of immunosuppressive regimens, blood product administration, drug interactions as well as the risk and benefits of invasive monitoring in these immunosuppressed patients. This article reviews the post-transplant physiology and anesthetic considerations for patients after solid organ transplantation.

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Intestinal transplantation

Cited by 28 publications

References 88 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

Anesthetic Considerations in Transplant Recipients for Nontransplant Surgery

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