OBJECTIVES: To investigate the activity alterations of enzymes in intestine grafts after liver/small bowel transplantation in rats and the relations of these changes to immune rejection of grafts. METHODS: A model of ...OBJECTIVES: To investigate the activity alterations of enzymes in intestine grafts after liver/small bowel transplantation in rats and the relations of these changes to immune rejection of grafts. METHODS: A model of liver/small bowel transplantation (LSBT) was established in closed colony SD and Wistar rats. The activity of enzymes including triphosphatase (ATPase), alkalinophosphatase (AKP), acytelcholinesterase (AchE), oxidesynthase (NOS) and monoamine oxidase (MAO) in bowel grafts was studied histochemically at regular postoperative intervals. RESULTS: The activity of enzymes in the wall of the grafts disappeared eventually in isolated small bowel transplantation (SBT) rats. In contrast, the activity in LSBT rats remained and recovered postoperatively. CONCLUSIONS: The rejection in grafted intestine could be prevented or delayed in LSBT rats. The changes in the activity of enzymes and neurons might be used to detect the rejection and function of the graft.展开更多
BACKGROUND Small bowel obstructions(SBOs)are common following a large intra-abdominal operation;however,SBOs caused by bezoars are unreported in patients following liver-kidney transplantation procedures,particularly ...BACKGROUND Small bowel obstructions(SBOs)are common following a large intra-abdominal operation;however,SBOs caused by bezoars are unreported in patients following liver-kidney transplantation procedures,particularly in adults.CASE SUMMARY A 65-year-old Caucasian female presented with nausea and nonbilious emesis during her postoperative course following a simultaneous liver-kidney transplantation.She developed worsening nausea and vomiting with significant abdominal distension and obstipation.Computed tomography imaging showed a marked abnormal dilation of multiple small bowel loops with a distinct transition point that was suggestive of a small bowel obstruction.An exploratory laparotomy revealed a foreign body in the intestinal track approximately 30 cm from the ileocecal valve.The foreign body was extracted and identified as a bezoar with hair follicles and old digestive contents.Following the operation,the patient demonstrated rapid clinical improvement with resolution of nausea,emesis,and progress in bowel motility.CONCLUSION SBOs caused by bezoars can occur immediately following a liver-kidney transplantation and should not be discounted as a diagnosis.展开更多
BACKGROUND: A simultaneously transplanted liver shields a bowel graft from immunologic attack in small animals, while the possible immuno-tolerance induced by the liver in liver and small bowel transplantation (LSBT) ...BACKGROUND: A simultaneously transplanted liver shields a bowel graft from immunologic attack in small animals, while the possible immuno-tolerance induced by the liver in liver and small bowel transplantation (LSBT) is uncertain in large animal models. To investigate the clinically suspected beneficial effect of the liver on small bowel allograft, we developed a new model of composite LSBT in the pig. METHODS: Seventy outbred long-white pigs were randomized into four groups. LSBT without immunosuppressive treatment (n=10, group A); LSBT with routine immunosuppressive treatment (n=10, group B); LSBT with a lower dose of immunosuppressive treatment (n=10, group C); and small bowel segment allotransplantation without immunosuppressive treatment (n=10, group D). RESULTS: There was no remarkable difference in survival time between groups A and D (10.33 vs. 12.89 days, P>0.05), but the initial time of acute rejection of the intestinal graft in group A was clearly delayed when compared to group D (8.22 vs. 4.33 days, P<0.05), and the rejection scores in group A were remarkably lower than those in group D at each postoperative time point (0 vs. 0.44 on day 3, P<0.05; 0.22 vs. 1.78 on day 5, P<0.05; 1.11 vs. 2.56 on day 7, P<0.05). There were evident differences in postoperative survival time, initial time of acute rejection and postoperative rejection scores between groups A, B and C. Postoperative survival time (30.00 vs. 28.13 days, P>0.05), initial acute rejection time (25.40 vs. 22.13 days, P>0.05) or rejection score did not differ between groups B and C within one postoperative month. CONCLUSIONS: Compared to isolated segment small bowel allotransplantation, the intestinal graft in LSBT (group A) had a delayed initial time of acute rejection and a lower postoperative acute rejection score, and a lower dose of immunosuppressive treatment led to persistent graft immuno-tolerance in LSBT. Thus the simultaneously transplanted liver graft may reduce the risk of intestinal rejection and protect the bowel graft from severe acute rejection.展开更多
基金This study was supported by the National Nature Science Foundation of China (No. 393700597) and Science Foundation of Ministry of Health, China (No. 0733-501).
文摘OBJECTIVES: To investigate the activity alterations of enzymes in intestine grafts after liver/small bowel transplantation in rats and the relations of these changes to immune rejection of grafts. METHODS: A model of liver/small bowel transplantation (LSBT) was established in closed colony SD and Wistar rats. The activity of enzymes including triphosphatase (ATPase), alkalinophosphatase (AKP), acytelcholinesterase (AchE), oxidesynthase (NOS) and monoamine oxidase (MAO) in bowel grafts was studied histochemically at regular postoperative intervals. RESULTS: The activity of enzymes in the wall of the grafts disappeared eventually in isolated small bowel transplantation (SBT) rats. In contrast, the activity in LSBT rats remained and recovered postoperatively. CONCLUSIONS: The rejection in grafted intestine could be prevented or delayed in LSBT rats. The changes in the activity of enzymes and neurons might be used to detect the rejection and function of the graft.
文摘BACKGROUND Small bowel obstructions(SBOs)are common following a large intra-abdominal operation;however,SBOs caused by bezoars are unreported in patients following liver-kidney transplantation procedures,particularly in adults.CASE SUMMARY A 65-year-old Caucasian female presented with nausea and nonbilious emesis during her postoperative course following a simultaneous liver-kidney transplantation.She developed worsening nausea and vomiting with significant abdominal distension and obstipation.Computed tomography imaging showed a marked abnormal dilation of multiple small bowel loops with a distinct transition point that was suggestive of a small bowel obstruction.An exploratory laparotomy revealed a foreign body in the intestinal track approximately 30 cm from the ileocecal valve.The foreign body was extracted and identified as a bezoar with hair follicles and old digestive contents.Following the operation,the patient demonstrated rapid clinical improvement with resolution of nausea,emesis,and progress in bowel motility.CONCLUSION SBOs caused by bezoars can occur immediately following a liver-kidney transplantation and should not be discounted as a diagnosis.
基金supported by a grant from the National Natural Science Foundation of China(30872484)
文摘BACKGROUND: A simultaneously transplanted liver shields a bowel graft from immunologic attack in small animals, while the possible immuno-tolerance induced by the liver in liver and small bowel transplantation (LSBT) is uncertain in large animal models. To investigate the clinically suspected beneficial effect of the liver on small bowel allograft, we developed a new model of composite LSBT in the pig. METHODS: Seventy outbred long-white pigs were randomized into four groups. LSBT without immunosuppressive treatment (n=10, group A); LSBT with routine immunosuppressive treatment (n=10, group B); LSBT with a lower dose of immunosuppressive treatment (n=10, group C); and small bowel segment allotransplantation without immunosuppressive treatment (n=10, group D). RESULTS: There was no remarkable difference in survival time between groups A and D (10.33 vs. 12.89 days, P>0.05), but the initial time of acute rejection of the intestinal graft in group A was clearly delayed when compared to group D (8.22 vs. 4.33 days, P<0.05), and the rejection scores in group A were remarkably lower than those in group D at each postoperative time point (0 vs. 0.44 on day 3, P<0.05; 0.22 vs. 1.78 on day 5, P<0.05; 1.11 vs. 2.56 on day 7, P<0.05). There were evident differences in postoperative survival time, initial time of acute rejection and postoperative rejection scores between groups A, B and C. Postoperative survival time (30.00 vs. 28.13 days, P>0.05), initial acute rejection time (25.40 vs. 22.13 days, P>0.05) or rejection score did not differ between groups B and C within one postoperative month. CONCLUSIONS: Compared to isolated segment small bowel allotransplantation, the intestinal graft in LSBT (group A) had a delayed initial time of acute rejection and a lower postoperative acute rejection score, and a lower dose of immunosuppressive treatment led to persistent graft immuno-tolerance in LSBT. Thus the simultaneously transplanted liver graft may reduce the risk of intestinal rejection and protect the bowel graft from severe acute rejection.
