Technical experiences with a microsurgical model of lymphatic reconstruction after intestinal transplantation in rats

The surgical procedure of intestinal transplantation disrupts the graft's lymphatic drainage. Despite morphological regeneration, the functional impairment of the lymphatic system may contribute to many pathophysiological changes after transplant. We describe the technical details and results of a microsurgical model of lymphatic reconstruction (LR), which immediately reconstitutes lymphatic drainage of the intestinal graft in rats. A total of 42 orthotopic intestinal transplants with LR was performed. The patency of the LR was assessed between postoperative days 2 and 100 using either methylene-blue staining of the lymphatic vessels or mesenteric lymphoradiography. A total patency rate of 88% was achieved. Genetic background, occurrence of rejection, and immunosuppressive treatment with cyclosporine did not affect the patency rate. Technical aspects and potential applications of this model are discussed.