Study of the impact of liver transplantation on the outcome of intestinal grafts in children

Myriam Jugie, Danielle Canioni, Christine Le Bihan, Sabine Sarnacki, Yann Revillon, Dominique Jan, Florence Lacaille, Nadine Cerf-Bensussan, Olivier Goulet, Nicole Brousse, Diane Damotte

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Background. Successful small bowel transplantation remains a challenge due to the septic and immune content of the gut. The possible beneficial role of the liver was assessed in pediatric recipients of isolated intestinal and liver intestinal combined transplantation, receiving the same immunosuppressive therapy. Methods. Fifteen children who underwent small bowel transplantation (seven SbTx) or combined liver-small bowel transplantation (eight LSbTx) at a single center between 1994 and 1998 were retrospectively reviewed and compared with fifteen controls (eight normal and seven appendicitis as inflammatory control). Transplant and patient survival, acute rejection episodes were analyzed and compared. Epithelial apoptotic body counts (ABC) and NF-kB (p65), Caspase-3 and Bax intestinal immunostaining from days 0 to 20 after transplantation were assessed. Results. Graft and patient survivals at 5 years were respectively 75% and 75% in LSbTx; 43% and 57% in SbTx (NS). Histological analysis showed higher ABC in LSbTx intestinal mucosa (P=0.05 on day 5, P<0.01 thereafter). Immunostaining of biopsies on day 0 after reperfusion showed different expression of NF-kB, Caspase-3 and Bax on endothelial (P<0.05 for NF-kB and Bax), mononuclear (P<0.05 for Bax) and epithelial cells in LSbTx and SbTx. Conclusions. Our results suggest a protective role of the liver toward intestinal transplantation even in absence of significative difference, probably due to the small number of children. Early changes in NF-kB immunostaining in the biopsies sampled on day 0, pointed to a possible beneficial effect of the liver in the very early phase following transplantation, perhaps through the differential control of ischemia-reperfusion.

Original languageEnglish (US)
Pages (from-to)992-997
Number of pages6
JournalTransplantation
Volume81
Issue number7
DOIs
StatePublished - Apr 1 2006
Externally publishedYes

Keywords

  • Intestinal transplantation
  • Liver
  • Pediatric
  • Tolerance

ASJC Scopus subject areas

  • Transplantation

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