Abstract
Intestinal transplantation (IT) restores the vascular circulation and the luminal flow of the graft, although many other aspects of its morphological and functional integrity remain compromised after transplantation [1]. An important anatomical structure which is essential for normal gut function and initially disrupted by the transplant is the intestinal lymphatic drainage. As part of a complex network of vascular and lymphatic circulation, the intestinal lymphatic system collects lymph fluid from the small intestine, then drains it through the thoracic duct into the systemic circulation [2, 3]. Its function involves transporting absorbed lipids, providing a conduit for the migration of lymphocytes, and regulating interstitial fluid exchange [4]. Morphological regeneration of the lymphatic drainage becomes evident by 4 weeks after IT through small collaterals (Fig.4d) [5–7]. However, to what extent the disrupted lymphatic drainage impairs graft function and immunology and how the collaterals mimic a physiological lymphatic drainage is poorly understood. A novel microsurgical model that reconstitutes lymphatic drainage immediately after IT was developed by Szymula von Richter and his colleagues in 1996 [8]. Recently, we modified this model, achieving a success rate of 87%. We describe here the details of this microsurgical model, the assessment of the patency of lymphatic anastomosis, and potential applications.
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References
Lear PA (1994) The physiology of the transplanted small intestine. In: Grant D, Wood RFM (eds) Small bowel transplantation. Arnold, London, pp 18–29
Ohtani O (1987) Three-dimensional organization of lymphatics and its relationship to blood vessels in rat small intestine. Cell Tissue Res 248:365–374
Tilney NL (1971) Patterns of the lymphatic drainage in the adult laboratory rat. J Anat 109:369–383
Barrowman JA (1978) Physiology of the gastro-intestinal lymphatic system. Cambridge University Press, Cambridge
Schmid T, Koeroezsi G, Oberhuber G, Klima G, Margreiter R (1990) Lymphatic regeneration after small bowel transplantation. Transplant Proc 22:2060–2061
Schier F, Üner A, Waldschmidt J (1991) Microlymphography of spontaneous lymph vessel anastomosis in small bowel transplantation in the rat. J Pediatr Surg 26:1239–1242
Liu H, Teraoka S, Nozawa M, Fujita S, Fuchinoue S, Takahashi K, Agishi T, Ota K (1992) Successful lymphangiographic investigation of the mesenteric lymphatic regeneration after orthotopic intestinal transplantation in rat. Transplant Proc 24:1113–1114
Szymula von Richter TP, Baumeister RG, Hammer C (1996) Microsurgical reconstruction of the lymphatic and nerve system in small bowel transplantation: the rat model, first results. Transplant Int 9 [Suppl l]:286–289
Baumeister RG, Seifert J, Liebich H, Wiebecke B, Gabka C, Goldmann U (1985) The rat model as precursor of clinical lymph vessel transplantation. In: Thiede A, Deltz E, Hamelmann H (eds) Microsurgical models in rats for transplantation research. Springer, Berlin Heidelberg New York, pp 113–116
Kitagawa H, Ford EG, Sinatra F, Thomas D, Atkinson JB (1991) Fecal fat, cyclosporine, and α1-antitrypsin for assessment of small bowel function following transplantation. J Pediatr Surg 26:1091–1096
Sigalet DL, Kneteman NM, Fedorak RN, Kizilisik AT, Thomson AB (1992) Intestinal function following allogeneic small intestinal transplantation in the rat. Transplantation 53:264–271
Grant D, Hurlbut D, Zhong R, Wang P, Chen H, Garcia B, Behme R, Stiller C, Duff J (1991) Intestinal permeability and bacterial translocation following small bowel transplantation in the rat. Transplantation 52:221–224
Demetris AJ, Murase N, Ye Q, Galvao FH, Richert C, Saad R, Pham S, Duquesnoy RJ, Zeevi A, Fung JJ, Starzl TE (1997) Analysis of chronic rejection and obliterative arteriopathy. Possible contributions of donor antigen-presenting cells and lymphatic disruption. Am J Pathol 150:563–578
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Kellersmann, R., Grant, D., Zhong, R. (1998). Lymphatic Reconstruction after Intestinal Transplantation in Rats. In: Timmermann, W., Gassel, HJ., Ulrichs, K., Zhong, R., Thiede, A. (eds) Organtransplantation in Rats and Mice. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72140-3_40
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DOI: https://doi.org/10.1007/978-3-642-72140-3_40
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