Early clinical and histologic viability of human liver-small intestinal allografts after implantation
Abstract
Our procedure for donor harvesting and preserving intestinal grafts has matured. In 27 consecutive cases, a protocol was established whose essentials consist of (a) selecting hemodynamically stable donors, (b) antibiotic pretreatment of the donor, and (c) short warm ischemic times (<40 minutes). Assessment of graft quality can be achieved by daily inspection of stomas, inspection for diarrhea >2.5 1/day in adults or >300 ml in children, and weekly protocol or clinically directed endoscopic biopsies. Edema and microscopic separation of the mucosal surface and sloughing are routinely found during the first few posl-engraftment days, but the crypt cells remain and regenerate a normal mucosa within a week. Recovery of a normal mucosal surface look place in all cases.
