Asrian, A

Bonet, H

Doria, C

Frezza, EE

Irish, W

Starzl, TE

Swaminathan, A

Todo, S

Venkataramanan, R

Warty, SV

PubMed

Name not available

Water, sodium, potassium, and d-Xylose absorption in canine small bowel transplantation

D-Scholarship@Pitt

Water, Sodium, Potassium; and o-Xylose Absorption in Canine Small Bowel Transplantation E.E. Frezza. A. Swaminathan. A. Asrian. C. Doria. H. Bonet. W. Irish, S.V. Warty, S. Todo, T.E. Starzl, and R. Venkataramanan WITH many successful advances occurring in clinical small bowel transplantation (SBT). attention needs to be directed to the effect that denervation. preservation, and immunosuppression have on the function of the SBT. The goal of the present study was to determine the absorptive function of ileum and jejunum after SBT. MATERIALS AND METHODS Orthotopic SBT was performed in dogs according to the technique of Lillhey.1 The intestinal absorption of water. sodium (Na). potassium (K). and D-xylose by the graft (jejunal and ileal seg-ments) was evaluated at various time periods after allotransplan-tation (alJotx) (n = 20; study days 3. 5. 7. and 10); alJotx treated with FK 506. 0.1 to 0.4 m,ykg per day. IV (n = 10: study days 21. :!5. and 35); autotransplantation lautotx) (n = 29: study days 7 and 14. I month. 3 months. 6 months. and 12 months); and in control nontransplanted (n = 6) animals. On the study day. jejunal and ileal segments (10 to 14 em) were isolated under Nembutal anesthesia (25 mg/kg) and perfused with a solution containing Na (120 mmoilLl. K (5 mmoi/L). and xylose (100 IL8I'mL) in water (292 mOsml at a constant rate of 1.17 mUmin over 45 minutes. The entire perfusate was collected over a IS-minute interval for a total of 45 minutes and measured for Na (flame photometryl. K (flame photometry), xylose (spectrophotometry). and water (mass balance). At the end of infusion. tissue samples were taken for histology and the animals were killed. Net absorption of Na. K. and xylose was calculated as the difference between the amount infused and the am0U:nt'- recovered over 45 minutes per unit segment length. Water absorption was estimated as the difference in the volume of solution infused and the volume recovered per unit length of the segment. Statistical significance. at a P < .05. was determmed using the Kruskal-Wallis ANOV A test. RESULTS The net absorption of xylose in control dogs was signifi-cantly different between the jejunum and the ileum (3.98 + 0.12 and 1.95 + 0.4 ~cm per minute). but not for water (8.9 ~ 4.4: 11.18 ~ 1.4 ~Ucm per minute). Na 10.1 ~ 0.005; 0.127 ~ 0.017 ~Eqicm per minutel. or K <0.01 ~ 0.001; 0.011 ~ 0.001 ~EqJcm per minute I. Electrolytes and xylose absorption was significantly lower during the im-mediate post-SST. but return to normal values in about 35 Jays In autotx and in 3 months in allot x dogs treated with FK 506. Maximum water absorption was observed after 35 Jays in autotx IP < .(003). and on day 7 in the allotx group (f> < .lKlO71. Sl!vere rejection. which occurred by day 10 in allot x nut treated with FK 506. I:aused an increased permeability of xylose «,:i.33 = 0.5: n.1 = 0.6 ~gJcm per minute} and water 1~0.7 = 0.9: ~0.7 = 1.05 ~Ucm per minute} from the ileum and the jl!junum. whereas Na (0.1 ::: 0.01: n.11 ~ (l.01 ~EqJcm per mmute) and K 10.01 TransplantatIOn Proceeamgs. Vol 26. No 3 (June). 1994: p 1661 ~ 0.0005; 0.01 ~ 0.001 J,LEqlcm per minute) permeability was similar to control values. DISCUSSION Our study indicates that. in normal dogs. xylose is ab-sorbed better in the jejunum than in the ileum; whereas such differences are not apparent with regards to water. Na. and K. The process of transplantation of the small bowel in itself is associated with alteration in the absorp-tive capacity of the small bowel for all the markers tested in allotx and autotx dogs. Our results are consistent with the repons of Sarr et a12•3 and Kimura et al;' who showed that complete extrinsic de nervation significantly alters the net absorption of water and Na in dogs and rats. respec-tively. Absorption of all the markers tested improved with time after transplantation in autotx dogs as well as in allotx dogs treated with FK 506. except for the secretory pattern observed transiently for water around week 3. In contrast. Watson' observed a decrease in net absorption of water and electrolytes with time in a rat model of jejunal trans-plantation. Our results indicate that absorption of xylose and water may not be useful as an indicator of an early graft rejection in this model. The increased xylose uptake during rejection is most probably related to the physical disruption of the mucosal side of the membrane. Lack of any relationship between D-xylose absorption and exten-sive graft rejection or GVHD have previously been docu-mented in pigs/> and in the nonhuman primate. 7 REFERENCES I. Lillehei RC. hJezuki Y. Feemster lA. t!l al: Surgery 62:7:!1. 1967 :!. Walters AM. Zinsmeister AR. Sarr MG: Transplantation «in press) 3. Hakim NS. Walters AM. Zinsmeister AR. et al: Surgery 110:394. 1992 4. Kimura K. LaRosa CA. Jaffe 8M: Surg Forum 40: 172. 1989 S. Watson AJM. Lear PA. Montgomery A. et al: Gastroenter-ology 94:863. 1988 6. Bim R. AndreoRl B. De Rai P. et al: Transplant Proc :!4:lln.I992 7. Hale DA. Waldort' A. Kleinschmidt J. et al: J Pediat Surg ~6:914. 1991 From the Departments of Surgery. Pathology. and Pharmaceu-tical Science. UniverSity of Pittsburgh Medical Center. Pittsburgh. PennsylvaOla. Address repnnt requests to Venkataramanan Raman. PhD. Depanment of Pharmaceutical Science. University of Pittsburgh Medical Center. 718 Salk Hall. Pittsburgh. PA 15261. c 1994 by Appleton & Lange 004 1-1345/94/$3.001 + 0 1661 

Water, sodium, potassium, and D-xylose absorption in canine small bowel transplantation

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Water, sodium, potassium, and D-xylose absorption in canine small bowel transplantation

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