Liver transplantation is a conventional treatment for terminal stage liver diseases. However, several complications still hinder the survival rate. Intestinal barrier destruction is widely observed among patients receiving liver transplant and suffering from ischemia-reperfusion or rejection injuries because of the relationship between the intestine and the liver, both in anatomy and function. Importantly, the resulting alteration of gut microbiota aggravates graft dysfunctions during the process. This article reviews the research progress for gut microbial alterations and liver transplantation. Especially, this work also evaluates research on the management of gut microbial alteration and the prediction of possible injuries utilizing microbial alteration during liver transplantation. In addition, we propose possible directions for research on gut microbial alteration during liver transplantation and offer a hypothesis on the utilization of microbial alteration in liver transplantation. The aim is not only to predict perioperative injuries but also to function as a method of treatment or even inhibit the rejection of liver transplantation.
Animals ; Gastrointestinal Microbiome ; Graft Rejection ; prevention & control ; Humans ; Intestinal Mucosa ; physiopathology ; ultrastructure ; Liver Transplantation ; Rats ; Reperfusion Injury ; prevention & control

BACKGROUNDPelvic organ prolapse (POP) is a major health concern that affects women. Surgeons have increasingly used prosthetic meshes to correct POP. However, the most common used is synthetic mesh, and absorbable mesh is less reported. This research aimed to evaluate the clinical effectiveness of porcine small intestinal submucosa (SIS).

METHODSConsecutive forty POP patients who met the inclusion criteria underwent pelvic reconstruction surgery with SIS between March 2012 and December 2013. The patients' clinical characteristics were recorded preoperatively. Surgical outcomes, measured by objective and subjective success rates, were investigated. We evaluated the quality of life (QOL) using the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7). Sexual QOL was assessed by the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-12 (PISQ-12).

RESULTSAt postoperative 12 months, the subjective recurrence rate (7.5%) was much lower than the objective recurrence rate (40.0%). Postoperatively, no erosion was identified. One underwent a graft release procedure because of urinary retention, and one had anus sphincter reconstruction surgery due to defecation urgency. Another experienced posterior vaginal wall infection where the mesh was implanted, accompanied by severe vaginal pain. Estrogen cream relieved the pain. One patient with recurrence underwent a secondary surgery with Bard Mesh because of stage 3 anterior vaginal wall prolapse. Scoring system of PFDI-20 was from 59.150 ± 13.143 preoperatively to 8.400 ± 4.749 postoperatively and PFIQ-7 was from 73.350 ± 32.281 to 7.150 ± 3.110, while PISQ-12 was from 15.825 ± 4.050 to 12.725 ± 3.471.

CONCLUSIONSQOL and the degree of subjective satisfaction were significantly improved postoperatively. Anterior repair deserves more attention because of the higher recurrence rate. The long-term follow-up of the patient is warranted to draw firm conclusion.

Aged ; Animals ; Female ; Humans ; Intestinal Mucosa ; transplantation ; Male ; Middle Aged ; Pelvic Organ Prolapse ; surgery ; Prospective Studies ; Surgical Mesh ; Swine ; Tissue Scaffolds

OBJECTIVE: To explore the histopathological changes of the new trachea reconstruction with a scraped partial mucosa jejunal autograft hy microscope and transmission electron microscope. METHOD: Eight canine models of extensive circumferential tracheal defects with revascularized jejuna combined with NiTi alloy mesh tube were established. Operations were performed on these dogs under general anesthesia by intravenous ketamine. A 6.5 cm length of segment of the jejunum was resected. The graft was prepared by scraping the partial mucosa with operating knife blade and dry gauze. During the resecting course, micro-vascular anastomoses were done between the mesenteric artery and the right common carotid artery,and the mesenteric vein with the right common carotid vein. The silicone intraluminal stent was placed in the lumen of the jejunal segment and was removed the fourth week after operation. A Ni-Ti alloy prothesis was placed over the jejunal segment, with the mesenteric vascular supply egressing through the longitudinal defect of the mesh tube. Then the free jejunum was used to reconstruct the tracheal defects. Biopsy were performed and recorded at the 1 at, 2nd, 3rd and 4th postoperative months. All specimens were observed by microscope and transmission electron microscope examinations. RESULT: Eight dogs postoperative all survived expected time. One month after operation, the tracheointestinal snastomosis showed smooth and was covered by continuous internal lining. The mucosa of the jejunum was slightly atrophied. Two months after operation, examination of the jejunal mucosa of the autografts demonstrated obviously thinned. The lumen of the reconstructed trachea was covered by squamous epithelium entirely at 3 months postoperatively. The partial squamous epithelium has transformed ciliated columnar epithelium at 4 months postoperatively. CONCLUSION A free scraped partial jejunum reconstructed trachea can accelerated the atrophying process of mucous epithelization and promoted mucosal metaplasia of the jejunum. The reconstructed tracheal lumen has completely transformed squamous epithelium at 3 months postoperatively and partial squamous epithelium has transformed ciliated columnar epithelium at 4 months postoperatively.
Animals ; Atrophy ; pathology ; Autografts ; Dogs ; Epithelium ; Intestinal Mucosa ; pathology ; transplantation ; Jejunum ; pathology ; transplantation ; Mucous Membrane ; pathology ; transplantation ; Nickel ; Reconstructive Surgical Procedures ; Stents ; Surgical Mesh ; Titanium ; Trachea ; surgery ; Transplantation, Autologous

We evaluated the biological scaffold properties of canine small intestinal submucosa (SIS) compared to a those of polypropylene mesh in growing rats with full-thickness abdominal defects. SIS is used to repair musculoskeletal tissue while promoting cell migration and supporting tissue regeneration. Polypropylene mesh is a non-resorbable synthetic material that can endure mechanical tension. Canine SIS was obtained from donor German shepherds, and its porous collagen fiber structure was identified using scanning electron microscopy (SEM). A 2.50-cm2 section of canine SIS (SIS group) or mesh (mesh group) was implanted in Sprague-Dawley rats. At 1, 2, 4, 12, and 24 weeks after surgery, the implants were histopathologically examined and tensile load was tested. One month after surgery, CD68+ macrophage numbers in the SIS group were increased, but the number of CD8+ T cells in this group declined more rapidly than that in rats treated with the mesh. In the SIS group, few adhesions and well-developed autologous abdominal muscle infiltration into the SIS collagen fibers were observed. No significant differences in the tensile load test results were found between the SIS and mesh groups at 24 weeks. Canine SIS may therefore be a suitable replacement for artificial biological scaffolds in small animals.
Abdominal Wall/*surgery ; Animals ; Biocompatible Materials/*therapeutic use ; Dogs ; Female ; Intestinal Mucosa/cytology/transplantation ; Intestine, Small/cytology/*transplantation ; Polypropylenes/*therapeutic use ; Rats ; Rats, Sprague-Dawley ; Tensile Strength ; Tissue Adhesions ; *Tissue Scaffolds ; Transplantation, Heterologous/*methods ; *Wound Healing

Here, we describe two dogs in which canine small intestinal submucosa (SIS) was implanted as a biomaterial scaffold during perineal herniorrhaphy. Both dogs had developed severe muscle weakness, unilaterally herniated rectal protrusions, and heart problems with potential anesthetic risks. Areas affected by the perineal hernia (PH) located between the internal obturator and external anal sphincter muscles were reconstructed with naive canine SIS sheets. In 12 months, post-operative complications such as wound infections, sciatic paralysis, rectal prolapse, or recurrence of the hernia were not observed. Symptoms of defecatory tenesmus also improved. Neither case showed any signs of rejection or specific immune responses as determined by complete and differential cell counts. Our findings demonstrate that canine SIS can be used as a biomaterial scaffold for PH repair in dogs.
Animals ; Biocompatible Materials ; Dog Diseases/*surgery ; Dogs ; Hernia, Abdominal/surgery/*veterinary ; Herniorrhaphy/veterinary ; Intestinal Mucosa/*transplantation ; Intestine, Small/*transplantation ; Male ; Perineum/surgery ; Postoperative Complications/veterinary ; Transplantation, Homologous/veterinary

OBJECTIVETo investigate the restoration of erectile function by reconstructing cavernous nerves (CN) with small intestinal submucosa (SIS) grafts.

METHODSWe prepared SIS grafts, established rat models and divided the models into a CN ablation, a sham-operation and an SIS graft group. The CNs at both sides were severed with 1 cm ablated in the first group, and 0.5 cm removed in the third, followed by reconstruction with the SIS grafts. Three months after surgery, the apomorphine test was performed to evaluate the erectile function, and then all the rats were sacrificed to detect the expression of nNOS in the penis.

RESULTSPenile erection was observed in 72.73% (8/11) of the rats for (1.07 +/- 0.89) times within 30 min in the SIS graft group, as compared with 0% (0/11) of the rats for (0.00 +/- 0.00) times in the CN ablation group (P < 0.01), and 90.91% (10/11) of the rats for (2.19 +/- 1.17) times in the sham-operation group (P < 0.01). The number of nNOS nerve fibers was significantly larger in the SIS graft than in the CN ablation group (70.36 +/- 10.09 versus 22.09 +/- 4.76, P < 0.01), but both were significantly smaller than that of the sham-operation group (90.81 +/- 5.69, P < 0.01).

CONCLUSIONThe SIS grafting technique contributes to the recanalization of the severed CN and restoration of erectile function in rats after surgical injury.

Animals ; Erectile Dysfunction ; surgery ; Intestinal Mucosa ; transplantation ; Intestine, Small ; Male ; Nerve Regeneration ; Nerve Tissue ; injuries ; surgery ; Penile Erection ; Penis ; innervation ; Rats ; Rats, Sprague-Dawley

Adult ; Biopsy ; Female ; Graft Rejection ; pathology ; Humans ; Intestinal Mucosa ; pathology ; Intestine, Small ; injuries ; pathology ; transplantation ; Male ; Organ Transplantation ; adverse effects ; Reperfusion Injury ; etiology ; pathology ; Young Adult

OBJECTIVETo investigate the restoration of rat penile erection by reconstructing injured cavernous nerves (CN) with a compound graft prepared from porcine small intestinal submucosa (SIS) and Schwann cells (SC).

METHODSSCs were cultured in vitro and a compound graft was prepared from the SCs and SIS. Thirty-three healthy SD rats were randomly divided into three groups of equal number, sham-operation, CN ablation, and SIS + SC graft. Three months after the operation, all the rats underwent the apomorphine test, followed by immunohistochemical staining of the tissues from the middle part of the corpus cavernosum penis.

RESULTSCombined use of mechanical stripping, mixed-enzyme digestion, different-speed adhesion, short-term Ara-C and some other methods yielded SCs of a purity high enough for nerve tissue engineering. The SIS prepared by mechanical and chemical methods exhibited a good biocompatibility with SCs, which could adhere, grow, propagate and differentiate on its surface. The apomorphine test showed that both the rate and frequency of penile erection were significantly higher in the SIS + SC graft than in the CN ablation group (P < 0.01), but lower than in the sham operation group (P < 0.01). The number of nNOS positive nerve fibers in the SIS + SC graft group was significantly different from that of the CN ablation (P < 0.01), but both were smaller than that of the sham-operation group.

CONCLUSIONThe compound of SIS with SCs, as a nerve graft, can be used to reconstruct injured cavernous nerves, and to some extent, restore penile erectile function.

Animals ; Intestinal Mucosa ; transplantation ; Intestine, Small ; Male ; Nerve Regeneration ; Penile Erection ; Penis ; innervation ; surgery ; Rats ; Rats, Sprague-Dawley ; Schwann Cells ; transplantation ; Swine ; Transplantation, Heterologous

BACKGROUND/AIMS: Bone marrow-derived cells (BMDC) contribute to tissue maintenance under many kinds of pathologic conditions. We carried out a study to see how BMDC play a role in the treatment of experimental murine colitis. METHODS: We divided the animals into 3 groups and treated them with 50% ethanol (control group), 2,4,6-trinitrobenzene sulfinic acid colitis (TNBS group), and TNBS+bone marrow transplant (BMT group). To induce colitis, TNBS (5.0 mg/mouse) dissolved in 50% ethanol was injected into anus weekly for two weeks. Bone marrow transplantations were performed using bone marrow of male transgenic mouse (donor) with green fluoresence protein (GFP) into female wild type mouse (recipient) three weeks before TNBS instillation. All animals were sacrificed, and colons were extracted one week after the last TNBS instillation. We measured microscopic scores of mucosal injury and investigated the GFP expression for bone marrow engraftment. The immunostaining of vimentin and alpha-smooth muscle actin (alpha-SMA) for myofibroblasts was performed. RESULTS: The score of mucosal injury in the TNBS group was much more severe than those in control, and reduced significantly by BMT (p<0.05). GFP-positive cells were almost deposited in pericryptal niche of BMT group but not at all in both control and TNBS group. Most of myofibroblasts stained with both vimentin and SMA also infiltrated into pericryptal niche. But, the number of myofibroblasts stained with vimentin and SMA in both control and TNBS group was smaller than that in BMT group. CONCLUSIONS: BMDC deposited on pericryptal niche might have a significant role in repairing acute experimental murine colitis.
Actins/metabolism ; Acute Disease ; Animals ; *Bone Marrow Transplantation ; Colitis/chemically induced/pathology/*surgery ; Female ; Fibroblasts/cytology ; Intestinal Mucosa/cytology ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Transgenic ; Transplantation, Homologous ; Trinitrobenzenesulfonic Acid/*toxicity ; Vimentin/metabolism

Hematopoietic stem cell transplantation (HSCT) can cause various complications involving lung, liver, intestine and other organs. Chemotherapy, radiation therapy, and graft-versus-host disease (GVHD) may injure the cells in the intestinal mucosa of HSCT recipients. Pneumatosis cystoides intestinalis (PI) is a condition that presence of air in the bowel wall is demonstrated by radiologic or pathologic tests. It is one of the infrequent complications after HSCT and is associated with several medical and surgical conditions. However its pathogenesis and definite etiologic factors are still unknown. Here, we present a case of PI in a HSCT recipient, who was diagnosed of bronchiolitis obliterance accompanied with chronic GVHD and pulmonary disease caused by Mycobacterium abscessus.
Bronchiolitis ; Bronchiolitis Obliterans ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Intestinal Mucosa ; Intestines ; Liver ; Lung ; Lung Diseases ; Mycobacterium ; Pneumatosis Cystoides Intestinalis ; Stem Cells ; Transplants