Luminal bacterial overgrowth and intestinal translocation in pigs given either cyclosporin A or 15-deoxyspergualin after small bowel transplantation

R. Biffi, G. Privitera, B. Andreoni, C. Matinato, S. Pozzi, L. Marzona, M. Danza, P. De Rai, G. Tiberio

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To examine the effects of two immunosuppressant regimens on composition of the bowel flora and rate of translocation after transplantation of the small bowel in pigs. Design: Randomised controlled study. Setting: University hospital, Italy. Material: 35 female Large White pigs. Interventions: 9 Animals were not operated on (normal controls). 19 Animals underwent total orthotopic small bowel allotransplantation and were then randomised to receive: group A (n = 8) cyclosporin A 25 mg/kg subcutaneously and cephazolin 2 g intramuscularly daily; group B (n = 6) 15-deoxyspergualin (15-dos) 3 mg/kg for 7 days then 1.5 mg/kg, cephazolin 2 g intramuscularly daily for 4 days then selective intestinal decontamination with colistin 1.5 million U, tobramycin 100 mg, vancomycin 1 g, and nystatin 500000 U daily; and group C (n = 5) cephazolin 2 g intramuscularly daily for 8 days. A further group (D, n = 7) underwent orthotopic autotransplantation and received the same antibiotic and selective decontamination regimens as group B. Animals in group C were killed on day 8, and the rest on day 29. Main outcome measures: Signs of rejection, graft versus host disease, luminal overgrowth, and evidence of translocation to mesenteric lymph nodes. Results: All animals in group C, and 2 in group B, showed signs of acute rejection. There was a significant overgrowth of both aerobic and anaerobic bacteria in all 3 groups after allotransplantation compared with normal controls. Bacterial translocation was similar in autografted and allotransplanted animals. Mesenteric lymph nodes were colonised in 4/9 controls, 7/8 in group A, 4/4 in group B, 5/5 in group C, and 7/7 in group D. Conclusion: Neither cyclosporin A nor 15-dos prevented luminal overgrowth or bacterial translocation to mesenteric nodes up to one month after operation. The rate of translocation was similar in autotransplantation and allotransplantation, suggesting that non-immunological factors (for example, denervation and interruption of lymphatics) may have a role in these alterations.

Original languageEnglish
Pages (from-to)93-96
Number of pages4
JournalEuropean Journal of Surgery, Acta Chirurgica
Volume161
Issue number2
Publication statusPublished - 1995

Keywords

  • 15-deoxyspergualin
  • cyclosporin A
  • graft rejection
  • graft versus host disease
  • intestinal translocation
  • pig
  • selective intestinal decontamination
  • small bowel transplantation

ASJC Scopus subject areas

  • Medicine(all)

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