Assessment of graft viability after cold preservation in small intestinal transplantation.

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The precise assessment of graft viability is thought to be important, however there are still a few methods which remain controversial. We investigated the method for the assessment of small bowel graft viability, by means of physiological properties, energy metabolism, tissue blood flow, and the histological findings.Syngeneic heterotopic transplantation was performed using Lewisrats, after a cold preservation of a jejunal graft with UW solution for 6, 12, 24, or 48hr. Graft samples were taken before transplantation for physiological study, and at harvesting, at the end of cold storage, before and 30 min after reperfusion for histology and for the measurement of adenine nucleotides (HPLC method). The tissue blood flow of the graft was recorded using a laserdoppler flowmeter at reperfusion.The positive rates of samples showing both the biphasic nervous activities (excitation and inhibition) and the spontaneous rhythmic activity was 100%, 88%, and 25% in 0, 24, and 48 hr preservation, respectively. The level of ATP after reperfusion, which recovered to more than 30% of that at harvesting within 24 hr preservation groups but remained at less than 30% in the 48 hr group. The blood flow level at 5 or 30 min of reperfusion was significantly lower in the 48 hr group than that in the other groups. Histological damage after reperfusion, which extended deep into the crypt layr in the 48 hr group, but was confinded within villi in the other groups, correlated well with the results of physiology, energy metabolism, and tissu blood folw.The physiological property before transplantation, and the tissue ATP level and blood flow after reperfusion are considered to be useful parameters for assessment of small bowel graft viability. These results are correlated with the recipient survival which we had previously reported.