[Flexibility of the surgical model of intestinal transplantation in swine]

To verify the feasibility to introduce variations in the technique of intestinal transplantation, we developed three different intestinal transplant models in pigs.

Feasibility and comparative study.

Pre-clinical organ transplant surgery.

Sixty outbread piglets (mean weight 27.1 +/- 4.4 kg) received a total orthotopic intestinal allograft from equivalent donors perfused through the aorta with UW solution at 4 degrees C. Intraluminal flushing of the graft was always avoided. The animals were divided in 3 groups according to the transplantation procedure adopted. Group 1 (n = 9): excision of small and large bowel and replacement with small bowel only; group 2 (n = 39): excision of small bowel and its replacement; group 3 (n = 12): excision of small and large bowel and their "en-bloc" replacement. The superior mesenteric artery and vein were anastomosed end-to-end in all groups.

The lowest perioperative mortality occurred in group 2 (28%), followed by group 3 (58%) and group 1 (78%). However, in group 1 the incidence of perioperative deaths was influenced by our learning curve in surgical and anesthesiologic management. No significant differences were noted in terms of cold and warm ischaemia time of the grafts, length of operative time, histopathologic analysis of preservation injury. The addition of the colon in the transplanted graft resulted in a more critical hemodynamic profile at reperfusion.

Three different experimental models of intestinal transplantation are feasible in pigs. The choice can be made based on the type of study needed.