Combined small bowel and reduced liver transplantation in pigs.
OBJECTIVE
Small bowel transplantation is a last resort treatment for intestinal insufficiency. Although the disorder is occasionally associated with chronic hepatopathy of variable severity, it may require simultaneous liver transplantation. We present a new model of heterotopic small bowel and reduced partial liver transplantation to an infrahepatic site.


METHODS
"Mini-pig" breed pigs weighing 28 to 35 kg were divided into four experimental transplant groups: intestine only (IO) without immunosuppression (group 1A, n = 11); IO with immunosuppression (group 1B, n = 10); intestine + reduced liver (IRL) without immunosuppression (group 2A, n = 12); IRL with immunosuppression (group 2B, n = 10).


RESULTS
Overall mortality from technical causes (first 3 days) was 23/43 animals (53.4%). All animals in group 1A displayed rejection, which was the main cause of death. Rejection occurred in 1 animal in each of the other three groups.


CONCLUSIONS
Heterotopic small bowel-reduced liver transplant is a multivisceral model that has the technical advantage of not requiring hepatectomy, and the immunological advantages of delayed appearance of acute rejection and the possibility of reducing immunosuppression during the first postoperative days.
Calleja Kempin
J
J
Department of General Surgery and Digestive Diseases, Gregorio Marañón, University General Hospital, Madrid, Spain.
Martín Cavanna
J
J
Vázquez Estevez
J
J
Alvarez
E
E
D000818:Animals; D005260:Female; D007165:Immunosuppression Therapy; D007421:Intestine, Small / Q000637:transplantation*; D016031:Liver Transplantation / Q000379:methods / Q000502:physiology*; D008297:Male; D013552:Swine; D013556:Swine, Miniature