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Related Experiment Videos

Method for diagnosing rejection in small bowel transplantation

R Grover1, P A Lear, C L Ingham Clark

  • 1Professional Surgical Unit, St Bartholomew's Hospital, West Smithfield, London, UK.

The British Journal of Surgery
|August 1, 1993
PubMed
Summary

Identifying host cells in small bowel transplants can be tricky. Host cells in the lamina propria aren't always rejection, but intraepithelial host cells specifically indicate rejection.

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Area of Science:

  • Immunology
  • Transplantation Biology
  • Gastroenterology

Background:

  • Diagnosing small bowel transplant rejection is challenging due to normal host lymphocyte trafficking to the graft.
  • Distinguishing physiological host cell infiltration from rejection-related infiltration is crucial for accurate diagnosis.

Purpose of the Study:

  • To compare physiological host cell infiltration with infiltration during rejection and stable immunosuppression in small bowel grafts.
  • To determine the diagnostic significance of host cell location within the graft.

Main Methods:

  • Small bowel transplantation was performed between DA and (DA x PVG) F1 hybrid rats to assess physiological infiltration.
  • Immunohistochemical analysis was used to quantify and localize host cell infiltration in graft tissues.

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  • Graft tissues were analyzed under conditions of physiological infiltration, rejection, and stable immunosuppression.

    • Main Results:

    • Significant host cell infiltration was observed in the lamina propria under physiological conditions, though less than in rejection or immunosuppression.
    • Host cells were detected in the intraepithelial compartment exclusively during rejection.
    • Physiological host cell infiltration in the lamina propria does not necessarily indicate rejection.

    Conclusions:

    • Histological identification of host cells in the lamina propria alone is insufficient to diagnose small bowel transplant rejection.
    • The presence of host cells within the intraepithelial compartment is a specific indicator of rejection in small bowel transplantation.
    • This finding aids in refining diagnostic criteria for small bowel transplant rejection.