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Optimal Solution Volume for Luminal Preservation: A Preclinical Study in Porcine Intestinal Preservation
M Oltean1, M Papurica2, L Jiga3
1University of Medicine and Pharmacy Timisoara, Romania; Institute of Clinical Sciences, Department of Surgery, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
Transplantation Proceedings
|April 26, 2016
Summary
Polyethylene glycol (PEG) solution preserves intestinal tissue's apical membrane and tight junctions during cold storage. However, high volumes may increase tissue edema, worsening intestinal morphology.
Area of Science:
- Gastroenterology
- Transplantation
- Surgical Research
Background:
- Rodent studies suggest luminal solutions improve intestinal preservation.
- Concerns exist regarding potential tissue edema with excessive luminal fluid volumes.
- Large animal studies are necessary to bridge the gap between rodent research and human clinical application.
Purpose of the Study:
- To evaluate the efficacy of polyethylene glycol (PEG) 3350 solution in preserving intestinal segments in a large animal model.
- To determine the optimal volume of PEG solution for intestinal preservation, assessing its impact on tissue edema and morphology.
Main Methods:
- Intestinal segments from 7 pigs were procured and perfused with histidine-tryptophan-ketoglutarate (HTK) solution.
- Segments were filled with varying volumes of 13.5% PEG 3350 solution (0.5–2 mL/cm) or no solution (controls).
- Tissue and luminal samples were analyzed after 8, 14, and 24 hours of cold storage (CS) for preservation injury (Chiu score), apical membrane integrity (ZO-1, maltase activity), and electrolyte content.
Main Results:
- Control intestines showed minimal injury at 8 hours, progressing to significant edema by 24 hours, with gradual ZO-1 loss but unaltered maltase activity.
- High PEG volumes (2 mL/cm) accelerated edema development and worsened histology compared to controls.
- PEG solution preserved ZO-1 better over time but reduced maltase activity; luminal sodium decreased similarly across groups.
Conclusions:
- PEG solution demonstrates protective effects on the intestinal apical membrane and tight-junction proteins during cold storage.
- Excessive luminal PEG volumes (>2 mL/cm) may promote water absorption, leading to submucosal edema and compromised intestinal morphology.
- Further research is needed to optimize PEG solution volume for safe and effective intestinal preservation.
