The optimal intestinal segment length for experimental size-mismatched intestinal transplantation: Defining the maximum length with the lowest blood flow needs in a porcine model.

Abstract

Transplanted Intestinal Segments (IS) must match the perfusion capacities of the recipient. This can be challenging during a size-mismatched SBTX. In this study, we defined the maximum IS length with lowest blood flow needs in a porcine model by evaluating the physiological perfusion rates of different IS lengths. Blood flow in the SMA, aorta segment four, and general circulatory parameters were monitored before and after sequential intestinal resection. IS lengths of 30cm, 60cm, 120cm, and 300cm (n=8 each) were compared. The IS blood flow requirements increased with IS length (30cm: 19.5±3.4mL/min; 60cm: 16.9±6.7mL/min; 120cm: 34.9±8.5mL/min; 300cm: 62.9±11.6mL/min). Absolute IS blood flow (P=.004), percentage IS blood flow uptake from the SMA (P=.001), and percentage IS blood flow uptake from the aorta (P=.005) increased significantly between 60cm and 120cm. We concluded that 60cm was the maximum IS length before blood flow demands significantly increased in a porcine model.