DOES THE ASSOCIATION OF TACROLIMUS AND MYCOPHENOLATE MOFETIL CHANGE THE HEALING OF THE ABDOMINAL WALL? STUDY IN RATS SUBMITTED TO ISCHEMIA AND KIDNEY REPERFUSION

André Luís Conde Watanabe,Jorge Eduardo Fouto Matias

doi:10.1590/0102-672020200004e1551

Abstract

ABSTRACT Background: Tacrolimus and mycophenolate mofetil are immunosuppressive agents widely used on the postoperative period of the transplants. Aim: To evaluate the influence of the association of them on the abdominal wall healing in rats. Methods: Thirty-six Wistar rats were randomly assigned in three groups of 12. On the early postoperative period, four of the control group and three of the experimental groups died. The three groups were nominated as follow: control group (GC, n=8); group I (GI, n=11, standard operation, mycophenolate mofetil and tacrolimus); group II (GII, n=10, standard operation, mycophenolate mofetil and tacrolimus). The standard operation consisted of right total nephrectomy and 20 min ischemia of the left kidney followed by reperfusion. Both NaCl 0.9% and the immunosuppressive agents were administered starting on the first postoperative day and continuing daily until the day of death on the 14th day. On the day of their deaths, two strips of the anterior abdominal wall were collected and submitted to breaking strength measurement and histological examination. Results: There were no significant differences in wound infection rates (p=0,175), in the breaking strength measurement and in the histological examination among the three groups. Conclusion: The combination of the immunosuppressive agents used in the study associated with renal ischemia and reperfusion does not interfere in the abdominal wall healing of rats.

Highlights

The significant increase in the number of organ transplants has required a better understanding of its early and late complications
The aim of this research was to evaluate the effects of the association of immunosuppressive agents tacrolimus and mycophenolate mofetil on the healing of the abdominal wall in rats submitted to total nephrectomy on the right and ischemia and reperfusion of the left kidney
The three groups received the following names with the respective numbers of animals: control group (GC), eight rats were submitted to the standard operation and to the administration of 0.9% sodium chloride solution; group I (GI), 11 animals with standard operation, administration of mycophenolate mofetil 20 mg/kg/day and tacrolimus 1 mg/ kg/day; group II (GII), 10 animals with standard operation and administration of mycophenolate mofetil 20 mg/kg/ day and tacrolimus 0.5 mg/kg/ day

Summary

Introduction

The significant increase in the number of organ transplants has required a better understanding of its early and late complications. In the postoperative period of solid organ transplants, high doses of immunosuppressants are administered early to prevent acute rejection. These agents inhibit the immune response that plays an important role in the inflammatory and cellular phase of healing and may increase the risk of dehiscence and incisional hernia. The use of immunosuppressive agents has been associated with complications in the wound healing process; experimental and clinical studies have produced contradictory results, demonstrating the need for additional research to assist daily clinical practice[16]. The aim of this research was to evaluate the effects of the association of immunosuppressive agents tacrolimus and mycophenolate mofetil on the healing of the abdominal wall in rats submitted to total nephrectomy on the right and ischemia and reperfusion of the left kidney

Objectives

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Results

Conclusion