Summary

Abstract

The study of intestinal structure and function following small-intestinal transplantation has been hindered in the large-animal model by the fact that there have been infrequent long-term survivors in both dog and pig models. The most recent work in a rat model. Both orthotopic and heterotopic, has allowed for isolation of rejection and graft-versus-host responses and more detailed immunologic assessment. In transplantation from Lewis-to-Brown Norway rats, there was more consistent long-term survival when cyclosporine was given an extended, but not indefinite, period, suggesting that this model of immunosuppression following small-bowel transplantation may be useful for such studies. Extrapolation to humans or to larger animals is difficult however, and it is unlikely that cessation of cyclosporine medication will result in long-term graft survivals. Nevertheless, the success of the experiment described by Schaut’s group provides some encouragement that successful clinical small-bowel transplantation using cyclosporine alone or in combination with other immunosuppressive agents may be possible.