title: A novel technique of hypothermic luminal perfusion for small bowel preservation.
abstract: BACKGROUND
  This study improved small bowel preservation using University of Wisconsin (UW) solution in conjunction with hypothermic luminal perfusion.
  
  
  METHODS
  Small bowels from Sprague-Dawley rats (n=4) were flushed vascularly with modified UW solution and flushed luminally: group 1, none (clinical control); group 2, UW solution; group 3, 1-hr oxygenated perfusion then static storage with UW; and group 4, 24-hr continuous oxygenated perfusion with UW. Energetics, lipid peroxidation, and histology were assessed during 24 hr at 4 degrees C.
  
  
  RESULTS
  After 12 hr, adenosine triphosphate ranged from 0.5 to 0.8 micromol/g in groups 1 to 3 compared with 1.5 micromol/g in group 4. Even after 24 hr, levels in group 4 were more than twofold greater than levels in groups 1 to 3. Energy charge values ([adenosine triphosphate+adenosine diphosphate/2]/total adenylates) decreased from fresh tissue values of 0.69 in all groups except group 4 throughout 24-hr perfusion. Malondialdehyde (MDA; a product of lipid peroxidation) doubled within 4 hr in group 1 and remained high throughout storage. In groups 3 and 4, MDA levels increased as the time of perfusion increased; group 2 showed no elevated MDA levels at any time. After 12 hr, histologic integrity was superior in groups 3 and 4; however after 24 hr, the best Park's grade was observed in group 3 (median grade 4) compared with groups 1 (grade 7) and 4 (grade 6).
  
  
  CONCLUSIONS
  Our data indicate that perfusion clearly improves tissue energetics; however, mucosal integrity is superior with only a brief 1-hr period of luminal perfusion, despite limited improvements in energetics.
authors.affiliation: Surgical-Medical Institute, University of Alberta, Edmonton, Canada.
authors.forename: Jay Z J
authors.initials: JZ
authors.lastname: Zhu
authors.forename: Erika G
authors.initials: EG
authors.lastname: Castillo
authors.forename: Payam
authors.initials: P
authors.lastname: Salehi
authors.forename: Jose
authors.initials: J
authors.lastname: Avila
authors.forename: Jonathan R T
authors.initials: JR
authors.lastname: Lakey
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Churchill
mesh_terms: D000227:Adenine Nucleotides / Q000378:metabolism; D000241:Adenosine; D000244:Adenosine Diphosphate / Q000378:metabolism; D000255:Adenosine Triphosphate / Q000378:metabolism*; D000493:Allopurinol; D000818:Animals; D004734:Energy Metabolism / Q000502:physiology; D005978:Glutathione; D007328:Insulin; D007421:Intestine, Small / Q000378:metabolism / Q000637:transplantation*; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions; D010477:Perfusion / Q000379:methods*; D011887:Raffinose; D051381:Rats; D017207:Rats, Sprague-Dawley; D014184:Transplantation, Homologous / Q000502:physiology*
chemical_list: D000227:Adenine Nucleotides; D007328:Insulin; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D008315:Malondialdehyde; D000244:Adenosine Diphosphate; D000493:Allopurinol; D000255:Adenosine Triphosphate; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose