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Graft, Vol. 5, No. 3, 135-140 (2002)
DOI: 10.1177/1522162802005003004
© 2002 SAGE Publications

Chronic Rejection after Rat Liver–Small Bowel Transplantation

Detlef Meyer

Christoph Otto

Martin Gasser

Uwe Heemann

Karin Ulrichs

Arnulf Thiede

The pathogenesis of chronic rejection after small bowel transplantation is still not wellunderstood. Statistically, however, chronic allograft dysfunction in humans seems lessfrequent if small bowel is transplanted in combination with a liver. Therefore, the aim ofthis study is to establish an experimental model for investigation of this phenomenon.Results after combined liver–small bowel transplantation (with or without immunosuppression)have been compared with isolated small bowel transplantation in the BrownNorway-Lewis (BN-LEW) rat strain combination. Signs of rejection were evaluated byhistology, immunohistochemistry, and the rate of parenchymal apoptosis in the allografts.Graft survival after liver–small bowel transplantation was prolonged in concomitantliver–small bowel transplantation as compared with small bowel transplantationalone. Furthermore, not only less immunosuppression was needed to establishlong-term acceptance after a transient acute rejection, but tolerance was established afterliver–small bowel transplantation. However, without initial immunosuppression, amore severe acute rejection crisis resulted in chronic rejection even after liver–smallbowel transplantation. Concordant to results after human renal transplantation, the degreeof the early parenchymal injury in the allografts seems to be a reliable predictor forthe late onset of chronic rejection.

Key Words: small bowel transplantation • liver transplantation • chronic rejection • transplant vasculopathy

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