Abstract
The present study aims to evaluate protective effects of a novel histidine-tryptophan-ketoglutarate solution (HTK-N) and to investigate positive impacts of an additional luminal preservation route in cold storage-induced injury on rat small bowels. Male Lewis rats were utilized as donors of small bowel grafts. Vascular or vascular plus luminal preservation were conducted with HTK or HTK-N and grafts were stored at 4°C for 8 h followed by ex vivo warm oxygenated reperfusion with Krebs-Henseleit buffer for 30 min. Afterwards, intestinal tissue and portal vein effluent samples were collected for evaluation of morphological alterations, mucosal permeability and graft vitality. The novel HTK-N decreased ultrastructural alterations but otherwise presented limited effect on protecting small bowel from ischemia-reperfusion injury in vascular route. However, the additional luminal preservation led to positive impacts on the integrity of intestinal mucosa and vitality of goblet cells. In addition, vascular plus luminal preservation route with HTK significantly protected the intestinal tissue from edema. HTK-N protected the intestinal mucosal structure and graft vitality as a luminal preservation solution. Additional luminal preservation route in cold storage was shown to be promising.
Highlights
Small bowel transplantation (SBT) is an established therapy for intestinal failure patients [1]
Statistically significant difference was found in comparison between groups of histidine–tryptophan–k etoglutarate solution (HTK-N) vascular with or without luminal preservation but not between groups of HTK solution (Figure 1A–D,I)
The present study applied the novel preservation solution HTK-N in rat small bowel cold storage (CS) and evaluated its capacity to protect the integrity of intestinal structure and function
Summary
Small bowel transplantation (SBT) is an established therapy for intestinal failure patients [1]. During the course of SBT, ischemia–reperfusion injury (IRI) is inevitable throughout allograft procurement, preservation and subsequent transplantation with the intestinal mucosa being highly vulnerable to IRI [2]. The consecutive severe tissue damage [3] leads to an inflammatory response including complement activation, endothelial activation, neutrophil sequestration [4] and results in postoperative infection and rejection [5]. The current preservation strategy for intestinal grafts consisting of vascular perfusion followed by static cold storage (CS) with University of Wisconsin solution (UW) has not changed for decades and is still the gold standard [6,7]. Histidine–tryptophan–ketoglutarate (HTK) solution, an extracellular type and License 4.0 (CC BY)
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