Allogeneic anorectal transplantation in rats: technical considerations and preliminary results

• Published in: Scientific reports Vol. 6; no. 1; p. 30894
• Main Authors: Galvão, Flavio H. F., Waisberg, Daniel R., Seid, Victor E., Costa, Anderson C. L., Chaib, Eleazar, Baptista, Rachel Rossini, Capelozzi, Vera Luiza, Lanchotte, Cinthia, Cruz, Ruy J., Araki, Jun, D’Albuquerque, Luiz Carneiro
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 04.08.2016; Nature Publishing Group
• Subjects: 692/308/409; 692/308/575; Allografts; Anal Canal - transplantation; Anastomosis; Anastomosis, Surgical - methods; Animals; Anorectal; Aorta; Aorta - transplantation; Body weight; Body weight gain; Colostomy - adverse effects; Coronary vessels; Diarrhea; Fecal incontinence; Graft rejection; Histology; Humanities and Social Sciences; Male; Mesenteric Artery, Inferior - transplantation; Mucosa; multidisciplinary; Portal vein; Portal Vein - transplantation; Quality of Life; Rats; Rats, Inbred Lew; Rats, Wistar; Reconstructive Surgical Procedures - methods; Rodents; Science; Science (multidisciplinary); Surgery; Transplantation; Transplantation, Homologous
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/srep30894

Fecal incontinence is a challenging condition with numerous available treatment modalities. Success rates vary across these modalities, and permanent colostomy is often indicated when they fail. For these cases, a novel potential therapeutic strategy is anorectal transplantation (ATx). We performed four isogeneic (Lewis-to-Lewis) and seven allogeneic (Wistar-to-Lewis) ATx procedures. The anorectum was retrieved with a vascular pedicle containing the aorta in continuity with the inferior mesenteric artery and portal vein in continuity with the inferior mesenteric vein. In the recipient, the native anorectal segment was removed and the graft was transplanted by end-to-side aorta-aorta and porto-cava anastomoses and end-to-end colorectal anastomosis. Recipients were sacrificed at the experimental endpoint on postoperative day 30. Surviving animals resumed normal body weight gain and clinical performance within 5 days of surgery. Isografts and 42.9% of allografts achieved normal clinical evolution up to the experimental endpoint. In 57.1% of allografts, signs of immunological rejection (abdominal distention, diarrhea, and anal mucosa inflammation) were observed three weeks after transplantation. Histology revealed moderate to severe rejection in allografts and no signs of rejection in isografts. We describe a feasible model of ATx in rats, which may allow further physiological and immunologic studies.