A. Munoz-Abraham2, A. Alkukhun2, S. Judeeba2, R. Patron-lozano2, T. Alfadda2, A. Bertacco1,2, M. I. Rodriguez-Davalos1,2, J. P. Geibel2 1Yale University School Of Medicine,Transplantation/Surgery,New Haven, CT, USA 2Yale University School Of Medicine,Surgery,New Haven, CT, USA
Introduction: In the current transplantation era, new preservation techniques have been developed to further preserve the organs in an optimal status. Continuous perfusion for organs such as kidney, liver, heart and lung have already proven to have a value in comparison to static preservation. However few attempts have been done to develop or find the ideal technique to preserve intestinal grafts. The aim of this study was to assess the optimal preservation technique for intestinal grafts intended for transplantation by comparing the static cold preservation against continuous cold perfusion in a rat model.
Materials and
Methods:
Comparison between static cold preservation (Control Group) with University of Wisconsin (UW) Preservation Solution versus Continuous Cold Perfusion with UW for perfusion (UW Perfusion Group) or a Modified Preservation Solution (MPS) containing UW with L-Arginine (MPS Perfusion Group) with rat intestinal grafts.
30 cms. of Male Sprague-Dawley rats’s small intestine were procured. The intestinal lumen was flushed with HEPES solution (pH 7.40) to remove intestinal debris. Two intestinal loops (10 cm each) were then connected to two custom perfusion chambers of an intestinal perfusion device. One chamber received a constant flow of UW solution and the other MPS solution and both submerged in a bath of deionized water at 4°C. A third intestinal loop was placed in cold static preservation with UW solution. Intestinal tissue samples were taken at T0, T1 (1 hr), T3 (3 hrs.), and T6 (6 hrs.), fixed in Formalin at 10%, and sent to pathology for processing, analysis, and grading according to Park/Chiu Scoring System for Grading Intestinal Ischemia.
Results: Both the UW and the MPS Perfusion groups better preserved the intestine in comparison to the static cold preservation after T6.
Conclusion: Continuous cold perfusion can better preserve intestinal grafts when compared to static cold preservation. These early results might open the door for new techniques for intestine preservation for transplantation that can eventually be applied in the clinical setting. Based on this findings, the next goal of this study is to determine the ideal preservation solution for continuous cold perfusion of the intestinal graft.
