Graft mucosal blood flow is reduced prior to histologic evidence of rejection in mouse small bowel transplantation: a murine model

Abstract

THE SUCCESS of small bowel transplantation is hampered by vigorous and early acute rejection responses. At present, the diagnosis of acute rejection is based mainly on histology and endoscopy. The late onset of morphologic changes and the initial patchy pattern makes it hard to discover early. Therefore efforts continue to identify novel and effective means for early diagnosis of acute rejection in intestinal transplantation. It has been demonstrated that one of the first targets in acute rejection of the small bowel allograft is the vascular endothelial cells in the lamina propria. This response may result in early mucosal microcirculatory disturbances and progressive ischemia that eventual lead to morphologic changes. We assumed that this attack on the microvasculature would be reflected in mucosal blood perfusion. Mucosal perfusion was measured by means of laser Doppler flowmetry at different time intervals and compared with synchronous histologic samples.