Advertisement
Surgery
Advanced searchSave search
Research Article| Volume 117, ISSUE 5, P545-553, May 1995

Intestinal transplantation: Effects on ileal enteric absorptive physiology

  • Andrew J. Oishi
    Affiliations
    Gastroenterology Research Unit, Mayo Clinic Rochester, Minn. USA

    Department of Surgery, Mayo Clinic Rochester, Minn. USA

    Mayo Foundation, Rochester, Minn. USA
    Search for articles by this author
  • Michael G. Sarr
    Correspondence
    Reprint requests: Michael G. Sarr, MD, Gastroenterology Research Unit, Mayo Clinic, 200 First St. S.W., Rochester, MN 55905.
    Affiliations
    Gastroenterology Research Unit, Mayo Clinic Rochester, Minn. USA

    Department of Surgery, Mayo Clinic Rochester, Minn. USA

    Mayo Foundation, Rochester, Minn. USA
    Search for articles by this author
DOI:https://doi.org/10.1016/S0039-6060(05)80254-5
Intestinal transplantation: Effects on ileal enteric absorptive physiology
Previous ArticleRole of intravascular ultrasonography in detecting intravascular tumor thrombi: A preliminary report
Next ArticlePrevention of venous thrombosis in microvascular surgery by transmural release of heparin from a polyanhydride polymer
      This paper is only available as a PDF. To read, Please Download here.
      Background. The effects of small intestine transplantation on enteric physiology are poorly understood. After orthotopic jejunoileal autotransplantation, dogs develop a severe watery diarrhea and lose up to 15% of their body weight. The cause of these changes has not been explained. Our aim was to determine the influence of jejunoileal autotransplantation on ileal absorption of water, electrolytes, and bile salts and the effects of proabsorptive and prosecretory agents on ileal transport.
      methods. Seven dogs were studied before and at 2 and 8 weeks after in situ jejunoileal neural and lymphatic isolation (a model of small intestine autotransplantion). With a triple-lumen perfusion technique, net ileal fluxes of water, electrolytes, and bile salts were measured before and at 2 and 8 weeks after this model of jejunoileal autotransplantation. In addition, the effects of an intravenous infusion of vasoactive intestinal polypeptide (a prosecretory agent) and norepinephrine (a proabsorptive agent) on net transport were evaluated.
      Results. Dogs developed a profuse diarrhea after this model of autotransplantation. Ileal absorption of water and electrolytes decreased immediately (measured during operation), remained decreased for 2 weeks, and returned toward baseline by 8 weeks. A similar decrease in net flux of bile salts was shown at 2 weeks after transplantation and returned toward baseline by 8 weeks. The prosecretory response of vasoactive intestinal polypeptide on ileal fluxes of water and electrolytes was unchanged, whereas the proabsorptive response to norepinephrine increased after this model of autotransplantation.
      Conclusions. Jejunoileal autotransplantation decreases ileal absorption of water, electrolytes, and bile salts. The profuse watery diarrhea observed in dogs after small intestine autotransplantation may be a secretory and/or a bile salt-induced diarrhea related to the effects of jejunoileal denervation.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Lillehei RC
        • Idezuki Y
        • Feemster JA
        • et al.
        Transplantation of the stomach, intestine and pancreas: experimental and clinical observations.
        Surgery. 1967; 62: 721-741
        • Todo S
        • Tzakis AG
        • Abu-elmagd K
        • et al.
        Intestinal transplantation in composite visceral grafts or alone.
        Ann Surg. 1992; 216: 223-234
        • Thomas EM
        • Templeton D
        Noradrenergic innervation of the villi of the rat jejunum.
        J Auton Nerv Syst. 1981; 3: 25-29
        • Cooke HJ
        Neurobiology of the intestinal mucosa.
        Gastroenterology. 1986; 90: 1057-1081
        • Sarr MG
        • Duenes JA
        • Walters AM
        Jejunal and ileal absorptive function after a model of canine jejunoileal autotransplantation.
        J Surg Res. 1991; 51: 233-239
        • Sarr MG
        • Duenes JA
        • Tanaka M
        Jejunoileal autotransplantation: effects on small intestinal motility.
        J Surg Res. 1987; 38: 160-162
        • Sarr MG
        • Duenes JA
        • Tanaka M
        A model of jejunoileal in vivo neural isolation of the entire jejunoileum: transplantation and the effects of intestinal motility.
        J Surg Res. 1989; 47: 266-272
        • Sarr MG
        • Kelly KA
        Myoelectric activity of the autotransplanted canine jejunoileum.
        Gastroenterology. 1981; 81: 303-310
        • Barbezat GO
        Triple lumen perfusion of the canine jejunum.
        Gastroenterology. 1980; 79: 1243-1245
        • Herkes SM
        • Smith CD
        • Phillips SF
        • Sarr MG
        Jejunal responses to absorptive and secretory stimuli after canine jejunoileal autotransplantation [Abstract].
        Gastroenterology. 1992; 102: A213
        • Redfors S
        • Sjovall H
        The importance of nervous and humoral factors in the control of vascular resistance, blood flow distribution and net fluid absorption in the cat small intestine during hemorrhage.
        Acta Physiol Scand. 1984; 121: 305-315
        • Yaksh TL
        • Abay EO
        • Go VLW
        Studies on the location and release of cholecystokinin and vasoactive intestinal polypeptide in the rat and cat spinal cord.
        Brain Res. 1982; 242: 272-290
        • Thompson JC
        • Rose SG
        • Spanta AD
        • Quigley EM
        The long-term effect of jejunoileal autotransplantation on intestinal function.
        Surgery. 1988; 111: 62-68
        • Ballinger WF
        • Christy MG
        • Ashby WB
        Autotransplantation of the small intestine: the effect of denervation.
        Surgery. 1962; 52: 151-164
        • Hubel KA
        The effects of electrical field stimulation and tetrodotoxin on ion transport by the isolated rabbit ileum.
        J Clin Invest. 1978; 62: 1039-1047
        • Cooke HJ
        • Shonnard K
        • Wood JD
        Effects of neuronal stimulation on mucosal transport in guinea pig ileum.
        Am J Physiol. 1983; 245: G290-G296
        • Lear PA
        • Watson AJ
        • Crane PW
        • Farthington MJ
        • Wood RF
        Autonomic function limits mucosal transport in cyclosporine-treated small intestinal transplants.
        Transplant Proc. 1988; 20: 436-442
        • Ahmad S
        • Allescher HD
        • Manaka H
        • Manaka Y
        • Daniel EE
        Biochemical studies on opioid and α2-adrenergic receptors in canine submucosal neurons.
        Am J Physiol. 1989; 256: G957-G965
        • Morris AI
        • Turnberg LA
        The influence of a parasympathetic agonist and antagonist on human intestinal transport in vivo.
        Gastroenterology. 1980; 79: 861-866
        • Sjovall H
        • Brunsson I
        • Jodal M
        • Lundgren O
        The effect of vagal stimulation on net fluid transport in the small intestine of the cat.
        Acta Physiol Scand. 1983; 117: 351-357
        • Watson AJ
        • Lear PA
        • Montgomery A
        • et al.
        Water, electrolyte, glucose and glycine absorption in rat small intestinal transplants.
        Gastroenterology. 1988; 94: 863-869
        • Lear PA
        • Watson AJM
        • D'Ardenne J
        • Farthing MJG
        • Wood RFM
        Analysis of nutrient transport in successful small bowel transplants.
        Transplant Proc. 1987; 19: 1123-1124
        • Kimura K
        • LaRossa CA
        • Jaffe BM
        Effect of extrinsic denervation on jejunal handling of water and electrolytes in the rat.
        Surg Forum. 1989; 40: 172-174
        • Teitelbaum DH
        • Sonnino RA
        • Dunaway DJ
        • Stellin G
        • Harmel Jr, RP
        Rat jejunal absorptive function after intestinal transplantation: effects of extrinsic denervation.
        Dig Dis Sci. 1993; 38: 1099-1104
        • Walters AM
        • Zinsmeister AR
        • Sarr MG
        Effect of a model of canine jejunoileal orthotopic autotransplantation on jejunal and ileal transport of water and electrolytes.
        Dig Dis Sci. 1994; 39: 843-850
        • Hakim NS
        • Walters AM
        • Zinsmeister AR
        • Sarr MG
        Net absorption of water, electrolytes, glucose, and folate from the in vivo, neurally isolated canine jejunum.
        Surgery. 1992; 110: 394-401
        • Nelson DK
        • Sarr MG
        • Go VLW
        In vivo neural isolation of the canine jejunoileum: temporal adaptation of enteric neuropeptides.
        Gut. 1991; 32: 1336-1341
        • Field M
        • McColl I
        Ion transport in rabbit ileal mucosa. III. Effects of catecholamines.
        Am J Physiol. 1973; 225: 852-857
        • Yeo CJ
        • Couse NF
        • Zinner MJ
        Discrimination between α1-and α2-adrenergic receptors in the isolated perfused ileum.
        Surgery. 1988; 104: 103-136
        • Brunner H
        • Hedwall PR
        • Maitre L
        • Maier M
        Antihypertensive effects of alpha-methylated catecholamine analogues in the rat.
        Br J Pharmacol Chemother. 1967; 30: 108-122
        • Weil-Malherbe H
        The passage of catecholamines through the blood-brain barrier.
        in: Vane JR Adrenergic mechanisms, CIBA Foundation Symposium. Little Brown and Company, Boston1960: 421-423
        • Soper NJ
        • Sarr MG
        • DiMagno EP
        • Kelly KA
        • Go VLW
        Effect of jejunoileal autotransplantation (extrinsic denervation) on postprandial pancreaticobiliary secretion.
        Surg Forum. 1989; XL: 168-170
        • Sarr MG
        • Walters AM
        • Benson JT
        • Zinsmeister AR
        Absorption of simple nutrients from the in vivo neurally isolated canine jejunum and ileum.
        Surgery. 1994; 115: 578-587

      Article info

      Publication history

      Accepted: September 29, 1994

      Footnotes

      *Supported in part by National Institutes of Health grant DK39337 and the Mayo Foundation.

      Identification

      DOI: https://doi.org/10.1016/S0039-6060(05)80254-5

      Copyright

      © 1995 Mosby-Year Book, Inc. Published by Elsevier Inc.

      ScienceDirect

      Access this article on ScienceDirect
      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties. The content on this site is intended for healthcare professionals.


      RELX