Intestinal ischemia-reperfusion injury – the histopathological status of remote vital organs in acute and subacute phases
Ján Varga, Štefan Tóth, Pavel Staško, Štefan Tóth Jr., Miroslava Bilecová-Rabajdová, Alexander Ostró, Jarmila Veselá
Ann Transplant 2012; 17(1): 11-20
Background: Improvement of graft recovery and function follows current trends in intestinal transplantation; however, the alteration of remote organs (RO) predicts complicated systemic rejection. This study was conceived to describe the histopathological status of RO arising in both acute and subacute stages after intestinal ischemia-reperfusion injury (IIR) injury.
Material/Methods: Wistar rats (n=54) were divided into 7 experimental groups (n=7 each). All the animals were subjected to 60 min mesenteric ischemia and subsequently to reperfusion 2 h, 4 h, 24 h, 72 h, 10 days, 20 days and 30 days following the groups IR2 h, IR4 h, IR24 h, IR72 h, IR10 d, IR20 d and IR30 d. As a control group (S; n=5) sham-operated animals were used. Histopathological scores (HPS) were evaluated in biopsies of the right kidney, heart and colon ascendens.
Results: Statistically significant increase in kidney HPS was seen during reperfusion, with the peak in IR4h group (p<0.01). Thereafter, improved morphology was observed; however, increased HPS was seen even in the subacute stage, and significant deterioration of HPS up to 10 days of reperfusion was detected (p<0.05). Heart biopsies also showed statistically increased HPS value in IR4h group (p<0.05). Intact morphology of the colon was detected in all reperfusion periods.
Conclusions: IIR causes a systemic reaction affecting RO. The peak of alteration for kidney and heart morphology was induced by 60 min of ischemia followed by 4 h of reperfusion. Thereafter, improved morphology was observed, although latent persistence of histopathological changes was seen even in the subacute stage. The colon remained intact during the whole experiment despite its anatomical proximity, confirming its high immunological capacity.
Keywords: Intestinal transplantation, remote organs, kidney, Heart, Colon, Reperfusion Injury