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Orthotopic small intestine transplantation in dogs with systemic graft drainage

机译:犬全身性小肠引流原位小肠移植

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BACKGROUND: Small intestine transplantation has been accepted worldwide to treat complex cases of intestinal failure. Canine intestinal transplantation model is important in training the surgical technique and to study the complications of this procedure. Systemic graft venous drainage is frequently performed in clinic, although the consequences of this partial meso-caval shunt have not been studied in detail. AIM: To describe the surgical technique and clinical outcome of a canine intestinal transplantation model using mesenteric-caval graft drainage. METHOD: Adult mongrel dogs from University of S?o Paulo Animal Facility, S?o Paulo, SP, Brazil, were used as donors and recipients in ten consecutives orthotopic intestinal transplantation with mesenteric-caval venous drainage. Clinical examination and body weight measurement were performed daily in all animals. Necropsy was performed in animals presenting moribund state (lethargic posture, diarrhea and loss of over 35% of body weight) to determine cause of death and histological changes. RESULTS: Three recipients died before day 2 from technical complications and were excluded from the experiment. The remaining seven animals developed signs of graft rejection with onset on days 3-4 and died or were sacrificed presenting severe graft rejection between days 7-9. Necropsy and histology of the graft confirmed the diagnosis of severe acute cellular rejection. CONCLUSION: Small intestine transplantation with systemic drainage in dogs courses with analogous and lethal outcome between postoperative day 7 to 9 due to strong graft rejection. This model serves as an excellent pre-clinical model to study the main complications related to this transplantation.
机译:背景:小肠移植已被世界范围内接受以治疗复杂的肠衰竭病例。犬肠移植模型对于训练手术技术和研究该手术的并发症至关重要。尽管还没有详细研究这种部分中腔分流的后果,但临床上经常进行全身性移植静脉引流。目的:描述采用肠系膜腔静脉移植引流的犬肠移植模型的手术技术和临床结果。方法:巴西圣保罗圣保罗大学动物设施的成年杂种犬被用作连续十次肠系膜腔静脉引流原位肠移植的供体和受体。每天对所有动物进行临床检查和体重测量。在表现为垂死状态(昏睡姿势,腹泻和体重减轻35%以上)的动物中进行尸检,以确定死亡原因和组织学变化。结果:三名接受者在第2天之前死于技术并发症,被排除在实验之外。其余7只动物在3-4天开始出现移植排斥反应的迹象,并在第7-9天死亡或处死,表现出严重的移植排斥反应。尸体解剖和组织学检查证实了严重急性细胞排斥反应的诊断。结论:由于强烈的移植物排斥反应,在术后第7天至第9天之间的狗疗程中,小肠移植加全身引流具有相似的致死性。该模型可作为研究此移植相关主要并发症的出色临床前模型。

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