Experience with intestinal transplantation in dogs

Application of intestinal transplantation to the clinical setting is very new. The main purpose of this project was to study graft rejection after intestinal transplantation. Ten pairs of male mongrel dogs, each weighing around 15 kg, were used as subjects. Intestinal transplantation of about one meter in length was done with end-to-end superior mesenteric artery and superior mesenteric vein anastomosis. University Wisconsin solution was used for graft preservation. Graft jejunostomy and ileostomy were also performed. Blood and tissue samples from jejunostoma and ileostoma were taken before and on days one, three, five, seven after operation. All dogs were sacrificed on the seventh postoperative day. Measurements were done of (1) blood lymphocyte count; (2) serum indicators of liver, renal function and nutritional indicators; (3) histopathologic changes of graft jejunum and ileum. Intestinal transplantation was performed successfully in ten pairs of dogs. The findings of rejection were that: (1) white blood cell and lymphocyte counts increased significantly from the fifth postoperative day; (2) lymphocyte infiltration into graft jejunum and ileum mucosa and submucosa area could be identified markedly from the fifth postoperative day; and (3) epithelium necrosis with micro abscess was noted on the seventh day. This suggests that the technique of intestinal transplantation is feasible, but that severe rejectional phenomenon is still a problem to be resolved.