[Flexibility of the surgical model of intestinal transplantation in swine].
OBJECTIVE
To verify the feasibility to introduce variations in the technique of intestinal transplantation, we developed three different intestinal transplant models in pigs.


METHODS
Feasibility and comparative study.


METHODS
Pre-clinical organ transplant surgery.


METHODS
Sixty outbread piglets (mean weight 27.1 +/- 4.4 kg) received a total orthotopic intestinal allograft from equivalent donors perfused through the aorta with UW solution at 4 degrees C. Intraluminal flushing of the graft was always avoided. The animals were divided in 3 groups according to the transplantation procedure adopted. Group 1 (n = 9): excision of small and large bowel and replacement with small bowel only; group 2 (n = 39): excision of small bowel and its replacement; group 3 (n = 12): excision of small and large bowel and their "en-bloc" replacement. The superior mesenteric artery and vein were anastomosed end-to-end in all groups.


RESULTS
The lowest perioperative mortality occurred in group 2 (28%), followed by group 3 (58%) and group 1 (78%). However, in group 1 the incidence of perioperative deaths was influenced by our learning curve in surgical and anesthesiologic management. No significant differences were noted in terms of cold and warm ischaemia time of the grafts, length of operative time, histopathologic analysis of preservation injury. The addition of the colon in the transplanted graft resulted in a more critical hemodynamic profile at reperfusion.


CONCLUSIONS
Three different experimental models of intestinal transplantation are feasible in pigs. The choice can be made based on the type of study needed.
Alessiani
M
M
Dipartimento di Chirurgia, Sezione di Chirurgia Generale A, IRCCS Policlinico San Matteo, Università degli Studi, Pavia.
Spada
M
M
Vaccarisi
S
S
Ferrari
P
P
Zanola
S
S
Merli
M
M
Iacona
I
I
Noli
S
S
Dionigi
P
P
Zonta
A
A
D000704:Analysis of Variance; D000818:Animals; D003106:Colon / Q000637:transplantation; D003627:Data Interpretation, Statistical; D005260:Female; D006439:Hemodynamics; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007420:Intestine, Large / Q000637:transplantation; D007421:Intestine, Small / Q000637:transplantation; D007422:Intestines / Q000637:transplantation*; D011182:Postoperative Care; D013552:Swine; D016559:Tacrolimus / Q000008:administration & dosage; D013997:Time Factors
D007166:Immunosuppressive Agents; D016559:Tacrolimus