Detailed analysis of mucosal restoration of the small intestine after the cavitary two-layer cold storage method.
Small bowel transplantation (SBT) is associated with a high incidence of infectious complications because of ischemia/reperfusion (I/R) mucosal injury concomitant with potent immunosuppression. In this study, we evaluated whether the cavitary two-layer method (cTLM) could reduce I/R injury and allow early mucosal restoration, particularly after prolonged preservation and transplantation. Canine heterotopic segmental SBT was performed immediately without preservation (group 1), after 24-h preservation in UW solution (group 2) or by the cTLM (group 3). The graft samples were taken 1 h after reperfusion and on days 1, 4 and 7. We assessed graft mucosa with detailed microscopic and electromicroscopic analyses. In Group 3, histological injury and cell apoptosis after transplantation were significantly alleviated and rapidly recovered to a similar level of group 1. The mucosal restoration was morphologically completed within 4 days. In contrast, in group 2, more pronounced mucosal injury and delayed recovery were noted. Crypt cell proliferation activity was well maintained in groups 1 and 3 throughout the experimental period. Our ultrastructural analysis suggested that mitochondrial integrity achieved by the cTLM was a basal mechanism under the prompt mucosal restoration. The cTLM could reduce I/R injury, facilitate mucosal regeneration and restore the nearly normal structure early after SBT.
Yoshikawa
Takuro
T
Division of Gastroenterological Surgery, Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Suzuki
Yasuyuki
Y
Fujino
Yasuhiro
Y
Kakinoki
Keitaro
K
Li
Shiri
S
Goto
Tadahiro
T
Tanaka
Tomohiro
T
Matsumoto
Ippei
I
Sakai
Tetsuya
T
Tanioka
Yasuki
Y
Yokozaki
Hiroshi
H
Kuroda
Yoshikazu
Y
D000818:Animals; D017209:Apoptosis; D049109:Cell Proliferation; D003080:Cold Temperature; D004285:Dogs; D005260:Female; D006085:Graft Survival; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000494:pharmacology; D020287:In Situ Nick-End Labeling; D007413:Intestinal Mucosa / Q000473:pathology*; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D008854:Microscopy, Electron; D046529:Microscopy, Electron, Transmission; D008928:Mitochondria / Q000473:pathology; D009092:Mucous Membrane / Q000473:pathology; D009926:Organ Preservation / Q000379:methods*; D016377:Organ Transplantation / Q000379:methods*; D011309:Preservation, Biological; D018809:Proliferating Cell Nuclear Antigen / Q000096:biosynthesis; D015424:Reperfusion; D015427:Reperfusion Injury / Q000473:pathology; D013997:Time Factors
D007166:Immunosuppressive Agents; D018809:Proliferating Cell Nuclear Antigen