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

目的评价对乙酰氨基酚（acetaminophen，AC）吸收试验作为大鼠原位小肠移植（orthopic small bowel transplantation，SBTX）排斥反应指标的有效性。原位同种异体SBTX（BN-至-刘易斯）使用袖套技术完成。简而言之，BN供体的20 cm近端空肠被外置作为移植物。供体肠系膜上动脉和门静脉与受体左肾动、静脉吻合。切除整个小肠，并将20 cm小肠移植物与十二指肠和剩余末端回肠端对端缝合。将所有实验动物分成如下五个实验组。A（n=9）：未试验对照。B（n=15）：刘易斯小肠扩大切除术，保留近端空肠20 cm和末端回肠2 cm。C（n=12）：无免疫抑制剂的同基因SBTX（Lewis-至-刘易斯）。D组（n=15）：同种异体SBTX + FK 506（0.1mg/kg/天）。E组（n=15）：同种异体SBTX + FK 506（0.5 mg/kg/天）。术后第1、3、7天，各组经胃管注入AC 0.15g/kg，15 min后测定血清AC水平。结果D组移植物从第1天（正常或轻度）到第3天（中度）和第7天（重度）表现为进行性急性排斥反应，D组血清AC水平从第1天开始显著下降（53.1 ± 0.001）。（3.9 μ g/ml）至第3天（35.0 μ g/ml）。[）12.0）和第7天（10.9（]SY. ±. [5.6]。结论急性排斥反应大鼠血清AC水平与组织学改变具有良好的相关性。AC吸收试验对SBTX移植物排斥反应的早期发现是有用的。

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.