title: Allogeneic anorectal transplantation in rats: technical considerations and preliminary results.
abstract: Fecal incontinence is a challenging condition with numerous available treatment modalities. Success rates vary across these modalities, and permanent colostomy is often indicated when they fail. For these cases, a novel potential therapeutic strategy is anorectal transplantation (ATx). We performed four isogeneic (Lewis-to-Lewis) and seven allogeneic (Wistar-to-Lewis) ATx procedures. The anorectum was retrieved with a vascular pedicle containing the aorta in continuity with the inferior mesenteric artery and portal vein in continuity with the inferior mesenteric vein. In the recipient, the native anorectal segment was removed and the graft was transplanted by end-to-side aorta-aorta and porto-cava anastomoses and end-to-end colorectal anastomosis. Recipients were sacrificed at the experimental endpoint on postoperative day 30. Surviving animals resumed normal body weight gain and clinical performance within 5 days of surgery. Isografts and 42.9% of allografts achieved normal clinical evolution up to the experimental endpoint. In 57.1% of allografts, signs of immunological rejection (abdominal distention, diarrhea, and anal mucosa inflammation) were observed three weeks after transplantation. Histology revealed moderate to severe rejection in allografts and no signs of rejection in isografts. We describe a feasible model of ATx in rats, which may allow further physiological and immunologic studies.
authors.affiliation: Laboratory of Experimental Transplant Surgery, LIM-37, Department of Gastroenterology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
authors.forename: Flavio H F
authors.initials: FH
authors.lastname: Galvão
authors.affiliation: Laboratory of Experimental Transplant Surgery, LIM-37, Department of Gastroenterology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Waisberg
authors.affiliation: Laboratory of Experimental Transplant Surgery, LIM-37, Department of Gastroenterology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
authors.forename: Victor E
authors.initials: VE
authors.lastname: Seid
authors.affiliation: Department of Pathology FMUSP, São Paulo, Brazil.
authors.forename: Anderson C L
authors.initials: AC
authors.lastname: Costa
authors.affiliation: Laboratory of Experimental Transplant Surgery, LIM-37, Department of Gastroenterology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
authors.forename: Eleazar
authors.initials: E
authors.lastname: Chaib
authors.affiliation: Laboratory of Experimental Transplant Surgery, LIM-37, Department of Gastroenterology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
authors.forename: Rachel Rossini
authors.initials: RR
authors.lastname: Baptista
authors.affiliation: Department of Pathology FMUSP, São Paulo, Brazil.
authors.forename: Vera Luiza
authors.initials: VL
authors.lastname: Capelozzi
authors.affiliation: Laboratory of Experimental Transplant Surgery, LIM-37, Department of Gastroenterology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
authors.forename: Cinthia
authors.initials: C
authors.lastname: Lanchotte
authors.affiliation: Intestinal Rehabilitation and Transplant Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Ruy J
authors.initials: RJ
authors.lastname: Cruz
authors.affiliation: Department of Plastic Surgery, University of Tokyo, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Araki
authors.affiliation: Laboratory of Experimental Transplant Surgery, LIM-37, Department of Gastroenterology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
authors.forename: Luiz Carneiro
authors.initials: LC
authors.lastname: D'Albuquerque
mesh_terms: D001003:Anal Canal / Q000637:transplantation*; D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001011:Aorta / Q000637:transplantation*; D003125:Colostomy / Q000009:adverse effects; D008297:Male; D017537:Mesenteric Artery, Inferior / Q000637:transplantation*; D011169:Portal Vein / Q000637:transplantation*; D011788:Quality of Life; D051381:Rats; D011917:Rats, Inbred Lew; D017208:Rats, Wistar; D019651:Plastic Surgery Procedures / Q000379:methods*; D014184:Transplantation, Homologous