Hidenori Kiyochi

Extrinsic sympathetic reinnervation after intestinal transplantation in rats

Although extrinsic denervation is inevitable after intestinal transplantation and leads to poor intestinal function, little is known about the occurrence of extrinsic reinnervation. In this study, extrinsic sympathetic reinnervation was investigated morphologically following syngeneic intestinal transplantation performed on male Lewis strain rats. At 1, 3, 6, 9, 15, and 27 weeks after transplantation, the graft mesenteric arteries and their branches in the intestinal wall were histochemically examined by a glyoxylic acid method demonstrating perivascular sympathetic nerve fibers. At 3 weeks after transplantation, extrinsic sympathetic reinnervation was recognized in the graft mesenteric arteries, where it traversed the arterial anastomosis and extended along the course of the mesenteric arteries from proximal to distal. The degree of reinnervation in the mesenteric arteries was similar to the results obtained in the simple denervation model. The transplanted intestinal tract itself was sympathetically denervated for at least 9 weeks after transplantation, and reinnervation was not recognized until 15 weeks after transplantation. Reinnervation extended into the intestinal wall in every preparation, and the enteric nerves began to be rein-nervated at 27 weeks after transplantation, but the density was still at a low level and complete extrinsic reinnervation of the graft would seem to require a much longer time to reestablish itself.

Significance of Serum Type IV Collagen Level of Hepatectomized Patients with Chronic Liver Damage

Type IV collagen, one of the serum markers for hepatic fibrosis, was measured perioperatively in patients with and without chronic liver damage to investigate whether this parameter changes in response to acute stress to the liver and can predict the surgical risk of hepatic resection. The serum type IV collagen level was significantly elevated in patients with liver cirrhosis. There were significant correlations between serum type IV collagen levels and the indocyanine green clearance test and cholinesterase activity, although the correlation coefficients were not high. The size of the resected hepatic mass was not the primary factor to influence the postoperative serum type IV collagen level. In patients with liver cirrhosis, the postoperative serum type IV collagen level increased significantly compared to that in patients with normal liver or chronic hepatitis. Postoperative liver failure occurred in 0%, 11.6%, and 44.4% of patients with preoperative serum type IV collagen levels of <150, ? 150 to 300, and ? 300 ng/ml, respectively. In those with postoperative liver failure, the serum type IV collagen levels were significantly higher both pre- and postoperatively compared to those in patients with uneventful courses. Several preoperative liver function tests indicated that type IV collagen is an independent risk factor for postoperative liver failure. Thus perioperative measurement of the serum type IV collagen levels seemed to be useful for predicting the risk of hepatic resection in patients with chronic liver damage.

Changes in the composition of serum bile acid as a predictor of small bowel allograft rejection in rats.

Composition of bile acid was studied as a noninvasive rejection marker after small bowel transplantation (SBT). Orthotopic SBT were performed in rats, and they were divided into four groups: group 1, sham-operated rats; group 2, recipients with isografts; group 3, recipients with allografts treated with FK506; and group 4, recipients with untreated allografts. On postoperative days (POD) 5 and 7, the graft histology, intraluminal bacterial overgrowth, individual bile acids concentration of the recipient serum and bile were examined. On POD 5, early histological findings of acute rejection were observed in group 4, and the ratio of secondary bile acids of this group were significantly higher than the other groups. The bile acid changes were enhanced by bacterial overgrowth on POD 7. The ratio of secondary bile acids changed in relation to acute rejection after SBT, suggesting that they can be useful for early diagnosis of acute SBT allograft rejection.

Rat-to-mouse small bowel xenotransplantation: a novel model for studying acute vascular and hyperacute xenograft rejection and xenogenic cell migration.

Kiyochi H, Kellersmann R, Blömer A, Garcia BM, Zhang Z, Zhong R and Grant DR.