The influence of short-term fasting on the quality of small bowel graft preservation.
BACKGROUND
Donor nutritional status may be a determinant of small bowel (SB) quality following storage. In this study, we investigated the effect of donor nutritional status and a proven nutrient-rich preservation solution on graft quality following cold storage.


METHODS
Rats were fasted (12-14 h) or non-fasted. SB (n=6) was flushed vascularly with modified University of Wisconsin (UW) solution and flushed luminally with UW or an amino acid-rich (AA) solution as follows: Fasted. UWV, none; UWL, UW solution; AAL, AA solution. Non-fasted. UWV, none; UWL, UW solution; AAL, AA solution. Energetics, peroxidation (malondialdehyde; MDA), glutathione and histology were assessed over 24 h at 4 degrees C.


RESULTS
Energetics (ATP, ATP/ADP, and energy charge) were significantly higher in AAL (fasted and non-fasted) groups than other groups. However, there were no differences in energetics parameters between fasted and non-fasted animals in all groups. MDA was higher in fasted groups than non-fasted tissues; interestingly, AAL values were up to 10-fold lower than other groups. Higher glutathione levels were detected in non-fasted AAL tissues. Mucosal integrity was markedly superior in luminally treated tissues (UWL and AAL) in fasted and non-fasted states. Most noteably, AAL tissues from fasted animals exhibited grade 2 injury (villus clefting), whereas normal mucosa was observed in non-fasted tissues (grade 0).


CONCLUSIONS
Luminal flushing and a nutrient-rich preservation solution improve energetics, oxidative stress, and mucosal integrity during storage. Poorer donor nutritional status does not affect energetics throughout storage, but causes mucosal injury as a result of increased oxidative stress, even after a brief period of donor fasting.
Salehi
Payam
P
Surgical-Medical Research Institute, 1074 Dentistry-Pharmacy Building, University of Alberta, Edmonton, Alta., Canada T6G 2N8.
Churchill
Thomas A
TA
D000241:Adenosine / Q000494:pharmacology; D000244:Adenosine Diphosphate / Q000378:metabolism; D000255:Adenosine Triphosphate / Q000737:chemistry / Q000378:metabolism; D000493:Allopurinol / Q000494:pharmacology; D000641:Ammonia / Q000378:metabolism; D000818:Animals; D050260:Carbohydrate Metabolism; D003080:Cold Temperature; D015925:Cryopreservation / Q000379:methods*; D005215:Fasting; D005508:Food Deprivation; D005978:Glutathione / Q000378:metabolism / Q000494:pharmacology; D007328:Insulin / Q000494:pharmacology; D007413:Intestinal Mucosa / Q000378:metabolism / Q000473:pathology; D007421:Intestine, Small / Q000378:metabolism / Q000473:pathology*; D007773:Lactates / Q000378:metabolism; D008297:Male; D008315:Malondialdehyde / Q000494:pharmacology; D009926:Organ Preservation / Q000379:methods*; D019188:Organ Preservation Solutions / Q000494:pharmacology; D018384:Oxidative Stress; D011887:Raffinose / Q000494:pharmacology; D051381:Rats; D017207:Rats, Sprague-Dawley; D013696:Temperature; D013997:Time Factors; D014180:Transplantation / Q000379:methods*
D007328:Insulin; D007773:Lactates; D019188:Organ Preservation Solutions; C055206:University of Wisconsin-lactobionate solution; D008315:Malondialdehyde; D000244:Adenosine Diphosphate; D000493:Allopurinol; D000641:Ammonia; D000255:Adenosine Triphosphate; D005978:Glutathione; D000241:Adenosine; D011887:Raffinose