The novel strategy with synbiotics therapy in small bowel transplantation

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【Aim】The aim of this study was to elucidate the beneficial effects of synbiotics therapy for acute rejection, bacterial translocation and alteration of organic acid as biomarker for acute rejection after small bowel transplantation in rats.【Material and Method】Orthotopic SBTx was performed and a 1.0ml portion of synbiotics was administered orally twice a day for 10days. Feces were sampled to detect the change of intestinal flora and the concentration of organic acids at day 5 and 10. At day 10, rats were sacrificed and several organs including liver, spleen, mesenteric lymph nodes, ascites and blood were obtained aseptically and cultured to evaluate the degree of bacterial translocation. Histological examination of the intestinal grafts was performed to define the acute rejection.【Results】Inhibition of growth in facultive anaerobesAll the population levels of facultative anaerobes such as Enterococcus, Enterobacteriaceae and Staphylococcus in synbiotics treatment group had a tendency to decrease on day 10.Concentration of organic acidsThe concentration of total organic acid and almost all the species had a tendency to increase in synbiotics treatment group, but only the concentration of acetic acid had a significant difference on day 10 between two groups.Bacterial TranslocationThe number of bacterial translocation in the donors' mesenteric lymph node and ascites was significantly difference between two groups.Acute rejection of intestinal graftThe scoring mean ±SD of histological evaluation of acute rejection had no significant difference was seen between two groups.【Conclusion】This study indicates synbiotics therapy plays a key role for the preservation of an intact intestinal barrier and reduces bacterial translocation in SBTx in rats. Synbiotics management for clinical small bowel transplantation could be a novel and essential therapeutic strategy to get a better graft function with a low incidence of infectious complication.