Intestinal transplantation: Effects on ileal enteric absorptive physiology

Andrew J. Oishi, Michael G. Sarr

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Background. The effects of small intestine transplantation on enteric physiology are poorly understood. After orthotopic jejunoileal autotransplantation, dogs develop a severe watery diarrhea and lose up to 15% of their body weight. The cause of these changes has not been explained. Our aim was to determine the influence of jejunoileal autotransplantation on ileal absorption of water, electrolytes, and bile salts and the effects of proabsorptive and prosecretory agents on ileal transport. methods. Seven dogs were studied before and at 2 and 8 weeks after in situ jejunoileal neural and lymphatic isolation (a model of small intestine autotransplantion). With a triple-lumen perfusion technique, net ileal fluxes of water, electrolytes, and bile salts were measured before and at 2 and 8 weeks after this model of jejunoileal autotransplantation. In addition, the effects of an intravenous infusion of vasoactive intestinal polypeptide (a prosecretory agent) and norepinephrine (a proabsorptive agent) on net transport were evaluated. Results. Dogs developed a profuse diarrhea after this model of autotransplantation. Ileal absorption of water and electrolytes decreased immediately (measured during operation), remained decreased for 2 weeks, and returned toward baseline by 8 weeks. A similar decrease in net flux of bile salts was shown at 2 weeks after transplantation and returned toward baseline by 8 weeks. The prosecretory response of vasoactive intestinal polypeptide on ileal fluxes of water and electrolytes was unchanged, whereas the proabsorptive response to norepinephrine increased after this model of autotransplantation. Conclusions. Jejunoileal autotransplantation decreases ileal absorption of water, electrolytes, and bile salts. The profuse watery diarrhea observed in dogs after small intestine autotransplantation may be a secretory and/or a bile salt-induced diarrhea related to the effects of jejunoileal denervation.

Original languageEnglish (US)
Pages (from-to)545-553
Number of pages9
JournalSurgery
Volume117
Issue number5
DOIs
StatePublished - 1995

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Autologous Transplantation
Transplantation
Bile Acids and Salts
Electrolytes
Diarrhea
Water
Dogs
Small Intestine
Vasoactive Intestinal Peptide
Norepinephrine
Denervation
Intravenous Infusions
Perfusion
Body Weight

ASJC Scopus subject areas

  • Surgery

Cite this

Intestinal transplantation : Effects on ileal enteric absorptive physiology. / Oishi, Andrew J.; Sarr, Michael G.

In: Surgery, Vol. 117, No. 5, 1995, p. 545-553.

Research output: Contribution to journalArticle

Oishi, Andrew J. ; Sarr, Michael G. / Intestinal transplantation : Effects on ileal enteric absorptive physiology. In: Surgery. 1995 ; Vol. 117, No. 5. pp. 545-553.
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abstract = "Background. The effects of small intestine transplantation on enteric physiology are poorly understood. After orthotopic jejunoileal autotransplantation, dogs develop a severe watery diarrhea and lose up to 15{\%} of their body weight. The cause of these changes has not been explained. Our aim was to determine the influence of jejunoileal autotransplantation on ileal absorption of water, electrolytes, and bile salts and the effects of proabsorptive and prosecretory agents on ileal transport. methods. Seven dogs were studied before and at 2 and 8 weeks after in situ jejunoileal neural and lymphatic isolation (a model of small intestine autotransplantion). With a triple-lumen perfusion technique, net ileal fluxes of water, electrolytes, and bile salts were measured before and at 2 and 8 weeks after this model of jejunoileal autotransplantation. In addition, the effects of an intravenous infusion of vasoactive intestinal polypeptide (a prosecretory agent) and norepinephrine (a proabsorptive agent) on net transport were evaluated. Results. Dogs developed a profuse diarrhea after this model of autotransplantation. Ileal absorption of water and electrolytes decreased immediately (measured during operation), remained decreased for 2 weeks, and returned toward baseline by 8 weeks. A similar decrease in net flux of bile salts was shown at 2 weeks after transplantation and returned toward baseline by 8 weeks. The prosecretory response of vasoactive intestinal polypeptide on ileal fluxes of water and electrolytes was unchanged, whereas the proabsorptive response to norepinephrine increased after this model of autotransplantation. Conclusions. Jejunoileal autotransplantation decreases ileal absorption of water, electrolytes, and bile salts. The profuse watery diarrhea observed in dogs after small intestine autotransplantation may be a secretory and/or a bile salt-induced diarrhea related to the effects of jejunoileal denervation.",
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