[Bacterial translocation in intestinal transplant].
OBJECTIVE
To analyse the influence of ceftriaxone on bacterial translocation and survival after small bowel transplantation in an experimental model with large animals.


METHODS
We performed 21 small bowel transplantation in pigs. Group 1 (n = 5): small bowel transplantation (SBT). Group 2 (n = 5): SBT and immunosuppression with cyclosporine, azathioprine and prednisolone. Group 3 (n = 5): SBT and ceftriaxone. Group 4 (n = 6): SBT, ceftriaxone and immunosuppression.


METHODS
Minipig of 25-45 Kg body weight.


METHODS
Blood, spleen, liver, and mesenteric lymph nodes for bacterial culture and biopsy of ileum on postoperative days POD 0.3 and 7.


RESULTS
Cultures were positive for bacteria in 22% (10/41) before perfusion, and 43% (28/67) post-reperfusion. Groups 1 and 2: cultures were positive for bacteria in 93% (28/30) on POD 3 degrees, and in 100% (30/30) on POD 7 degrees. Cultures were positive for enterobacteria in 80% (24/30) on POD 3 degrees. Groups 3 and 4: cultures were positive for bacteria in 79.5% (33/41) on POD 3 degrees and in 100% (31/31) on POD 7 degrees. Cultures were positive for enterobacteria in 36.5% (15/41) on POD 3 degrees. Early mortality (before POD 7 degrees), not related with technical complications was 50% (5/10) in groups 1 and 2 and 0% (0/11) in groups 3 and 4. There were no differences with the use of immunosuppression.


CONCLUSIONS
Ceftriaxone could decrease bacterial translocation (especially enterobacteria), and early mortality post-small bowel transplantation in pigs.
Jiménez Almonacid
P
P
Hospital General Universitario Gregorio Marañón, Madrid.
Calleja Kempin
J
J
Vázquez Estévez
J
J
Martín Cavanna
J
J
Jorgensen
T
T
D000818:Animals; D019072:Antibiotic Prophylaxis; D001379:Azathioprine / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D001420:Bacteria, Aerobic / Q000302:isolation & purification; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D018988:Bacterial Translocation; D001706:Biopsy; D002443:Ceftriaxone / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use*; D004755:Enterobacteriaceae / Q000302:isolation & purification; D005260:Female; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007421:Intestine, Small / Q000382:microbiology* / Q000637:transplantation*; D008297:Male; D013552:Swine; D013556:Swine, Miniature; D019737:Transplants / Q000382:microbiology*
D002511:Cephalosporins; D007166:Immunosuppressive Agents; D002443:Ceftriaxone; D001379:Azathioprine