Evaluation of the acetaminophen absorption test for the early detection of small bowel transplan

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PurposeWe evaluated the efficiency of acetaminophen (AC) absorption test as a marker of graft rejection in rats orthotopic small bowel transplantation (SBTX).Materials and MethodsBN rats were used as small bowel graft's donors and Lewis rats as recipients. Orthotopic allogenic SBTX (BN-to-Lewis) was accomplised using a cuff technique. In brief, 20 cm proximal jcjunum of BN donors was exteriorized as the transplant graft. The donor SMA and portal vein was anastmosed to the recipient's left renal artery and vein. The entire small bowel was resected, and a 20 cm small bowel graft was anastomosed end-to-end with the duodenum and the remaining terminal ileum. All experimental animals were divided into five experimental groups, as follows. A (n=9) : An untrated control. B (n=15) : Extended resection of Lewis small bowel remaining 20 cm of proximal jejunum and 2 cm of terminal ileum. C (n=12) : syngenic SBTX (Lewis-to-Lewis) without immunosuppressants. D (n=15) : allogenic SBTX with FK506 (0.1mg/kg/day). E (n=15) : allogenic SBTX with FK506 (0.5mg/kg/day). Serum AC levels were measured 15 minutes following instillation of 0.15 g/kg of AC through a gastric tube 1,3,7 postoperative day (POD) in each group. The jejunal graft removed from each animal were evaluated histologically.ResultsThe graft in group D showed the progressive acute rejection histologically from 1 POD (normal or mild) to 3 (moderate) and 7 (severe) POD.Serum AC levels in group D showed significant decrease from day 1 (53.1 (]SY.+-。[) 3.9mug/ml) to day 3 (35.0 (]SY.+-。[) 12.0) and day 7 (10.9 (]SY.+-。[) 5.6). No remarkable change of serum AC levels and histological findings was observed in the other four experimental groups.ConclusionThe good correlation between serum AC levels and histological changes were observed in rats that resulted in acute rejection. The AC absorption test appears to be useful for early detection of SBTX graft rejection.