P-02: Implication of NOD2 Polymorphisms in Intestinal Transplantation Recipients

Abstract

Preclinical models have significantly increased the knowledge on intestinal ischemia reperfusion injury (IRI). However, anesthesia method can have an important impact on the outcome, including survival. Surprisingly, this has been rarely studied. Gas-anesthesia with Isoflurane (Iso) is more easily administered than intraperitoneal injection of Ketamin-Xylazine (K+X) but may have distinct hemodynamic and/or anti-inflammatory effects. Using a rat model of IRI, we evaluated the effect of 3 anesthetic methods. Materials and Methods: Male Sprague-Dawley rats underwent 60min. of warm ischemia by clamping the superior mesenteric artery. 3 groups were studied (n=6/group; 60min. reperfusion): i/ K+X; ii/ K+X+O 2 ; iii/ Iso+O 2 . 1/ Blood pressure; 2/ serum endotoxin as marker for intestinal permeability (ELISA); 2/ Vascular permeability: endothelial glycocalyx markers (syndecan-1 and heparan sulfate (ELISA)); 3/ Inflammatory cytokines: IL-6 (ELISA), IL-1β (qPCR); and 4/ 7-day survival were determined (n=10/group). Results: K+X and K+X+O 2 led to progressive hypotension post-reperfusion whereas blood pressure normalized rapidly with Iso+O 2 . Iso+O 2 improved intestinal/vascular permeability, and systemic inflammation. Survival improved by addition of 100% O 2 (K+X+O 2 ) and even further with Iso+O 2 . (See table ). Conclusion: In a rat model of intestinal IRI, K+X anesthesia causes an ongoing low-flow ischemia that negatively affects outcome. O 2 supplementation and particularly O 2 + Isoflurane led to improved survival, intestinal and vascular permeability, and inflammation. The herein demonstrated effect of anesthesia on outcome needs to be considered in the choice of anesthetic method and in the interpretation of data.