Refined techniques for intestinal transplantation in rat.

Intestinal transplantation (IT), unlike other solid-organ transplantations, such as liver, kidney, and heart, has relatively disappointing results in humans. Significant advances have been made during the past 40 years, but rejection, graft-versus-host disease (GVHD), and infection remain the major obstacles to successful IT. These aspects may be studied using a rat model of IT. Without a microscope and traditional suture for vascular reconstruction, we simplified the procedure using a "three cuffs" technique for orthotopic intestinal transplantation (OIT). Technical modifications of our OIT model that induced good results included (1) adopting a "double cuffs" technique on the graft aorta, (2) using a portal cuff anastomosis to reconstitute the natural and physiologic portal graft drainage with the cuff fixed to the recipient first, and (3) administering a large volume of crystalloid or whole blood to maintain blood pressure and reduce ischemic injury to the graft during operation. In our group, the survival rate of recipients was 87.5% (21 of 24 rats), the average volume of bleeding in the recipient operation was less than 1 mL, and the cold ischemic time, 50 +/- 11 minutes.