Early clinical and histologic viability of human liver-small intestinal allografts after implantation.
Our procedure for donor harvesting and preserving intestinal grafts has matured. In 27 consecutive cases, a protocol was established whose essentials consist of (a) selecting hemodynamically stable donors, (b) antibiotic pretreatment of the donor, and (c) short warm ischemic times (< 40 minutes). Assessment of graft quality can be achieved by daily inspection of stomas, inspection for diarrhea > 2.5 1/day in adults or > 300 ml in children, and weekly protocol or clinically directed endoscopic biopsies. Edema and microscopic separation of the mucosal surface and sloughing are routinely found during the first few post-engraftment days, but the crypt cells remain and regenerate a normal mucosa within a week. Recovery of a normal mucosal surface took place in all cases.
Casavilla
F A
FA
Pittsburgh Transplantation Institute, PA.
Selby
R
R
Abu-Elmagd
K
K
Reyes
J
J
Nakamura
K
K
Wright
H I
HI
Tzakis
A
A
Todo
S
S
Demetris
A J
AJ
Fung
J J
JJ
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007413:Intestinal Mucosa; D007421:Intestine, Small / Q000473:pathology / Q000637:transplantation*; D017093:Liver Failure / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods; D008875:Middle Aged; D012778:Short Bowel Syndrome / Q000150:complications / Q000601:surgery