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The impact of jejunal transplant peristalsis on enteric flora
H Pernthaler1, A Eigentler, G Pfurtscheller
1Department of Transplant Surgery, University Hospital, Innsbruck, Austria.
Abstract:
The importance of phase III of the migrating myoelectric complex (MMC) for homeostasis of enteric flora is well documented. The goal of this study was to evaluate in an isogeneic rat model the effect of MMC changes on the self-purging capacity of the jejunal graft. The proximal 25% of the entire jejunoileum of Lewis rats was transplanted orthotopically. Electrodes were then fixed to the graft. Native bowel of five rats and five rats with analogue jejunal segmentation served as controls. Myoelectric recordings were carried out until day 21, when animals were killed for bacteriologic analysis of the segments analyzed myoelectrically and the of neighboring gut. MMCs were observed in all animals during all recordings. Phase III was irregular in transplants because of long-lasting periods of phase III absence alternating with phase III occurring more frequently. The variation coefficient of phase III periodicity calculated for grafts was 48.74, for native bowel 14.79, and for segmented jejunum 22.9. Enteric flora found in all specimens consisted of colonic-like microorganisms. Titers of microorganisms in grafts did not differ from control segments. These findings show that phase III periodicity is severely altered in jejunal grafts. Homeostasis of enteric flora, however, is not influenced by the transplant procedure.
Insights
Migrating myoelectric complex (MMC) phase III is crucial for gut flora. In jejunal grafts, phase III periodicity is altered, but enteric flora homeostasis remains unaffected by the transplant.
Area of Science:
- Gastroenterology
- Surgical Research
- Microbiology
Background:
- The migrating myoelectric complex (MMC) plays a vital role in maintaining the homeostasis of enteric flora.
- Phase III of the MMC is essential for the gut's self-purging capacity.
Purpose of the Study:
- To investigate the impact of altered migrating myoelectric complex (MMC) phase III on the self-purging capacity of jejunal grafts.
- To evaluate enteric flora homeostasis in orthotopically transplanted jejunal segments in an isogeneic rat model.
Main Methods:
- Orthotopic transplantation of the proximal jejunoileum in Lewis rats.
- Electromyographic recordings of myoelectric activity in jejunal grafts and control native bowel segments.
- Bacteriologic analysis of gut segments to assess enteric flora composition and titers.
Main Results:
- Migrating myoelectric complex (MMC) phase III periodicity was significantly irregular in jejunal grafts compared to native bowel and segmented jejunum.
- The variation coefficient of phase III periodicity was markedly higher in grafts (48.74) than in native bowel (14.79) or segmented jejunum (22.9).
- Despite altered phase III periodicity, the enteric flora in grafts consisted of colonic-like microorganisms, with no significant difference in microbial titers compared to control segments.
Conclusions:
- Jejunal transplantation leads to severe alterations in the periodicity of phase III of the migrating myoelectric complex (MMC).
- The homeostasis of enteric flora is not adversely affected by the observed changes in MMC phase III in jejunal grafts.
- The findings suggest resilience of enteric flora homeostasis despite functional changes in gut motility post-transplantation.