BACKGROUND: Control of allograft rejection remains the most difficult dilemma in intestinal transplantation. Standard endoscopic surveillance to date has not been always accurate in the diagnosis of rejection. We describe the first application of a zoom video endoscope in monitoring graft mucosa in humans after intestinal transplantation. METHOD: A zoom video endoscope, which can magnify the image up to 100-fold, was used in this study. The patient was a 31-year-old man who received an isolated intestinal transplant. Surveillance endoscopy with the zoom video endoscope was performed through the ileostomy. Endoscopic biopsies were done at the same time. RESULTS: The zoom video endoscope showed the microscopic architecture of the graft mucosa such as villi and crypts with outstanding quality. We found that an enlargement of the crypt areas appeared to correlate with morphologic changes of early rejection. This finding was reversed with the treatment of rejection. CONCLUSIONS: The zoom video endoscope successfully showed the detailed information of intestinal mucosa. The ability to visualize a more representative view of the graft mucosa could lead to better detection of early rejection. A greater experience with this unique method will provide more accurate assessment of the intestinal allograft.
BACKGROUND: Control of allograft rejection remains the most difficult dilemma in intestinal transplantation. Standard endoscopic surveillance to date has not been always accurate in the diagnosis of rejection. We describe the first application of a zoom video endoscope in monitoring graft mucosa in humans after intestinal transplantation. METHOD: A zoom video endoscope, which can magnify the image up to 100-fold, was used in this study. The patient was a 31-year-old man who received an isolated intestinal transplant. Surveillance endoscopy with the zoom video endoscope was performed through the ileostomy. Endoscopic biopsies were done at the same time. RESULTS: The zoom video endoscope showed the microscopic architecture of the graft mucosa such as villi and crypts with outstanding quality. We found that an enlargement of the crypt areas appeared to correlate with morphologic changes of early rejection. This finding was reversed with the treatment of rejection. CONCLUSIONS: The zoom video endoscope successfully showed the detailed information of intestinal mucosa. The ability to visualize a more representative view of the graft mucosa could lead to better detection of early rejection. A greater experience with this unique method will provide more accurate assessment of the intestinal allograft.
Authors: Seigo Nishida; David Levi; Tomoaki Kato; Jose R Nery; Naveen Mittal; Nicholas Hadjis; Juan Madariaga; Andreas G Tzakis Journal: J Gastrointest Surg Date: 2002 Mar-Apr Impact factor: 3.452
Authors: Andreas G Tzakis; Tomoaki Kato; David M Levi; Werviston Defaria; Gennaro Selvaggi; Debbie Weppler; Seigo Nishida; Jang Moon; Juan R Madariaga; Andre I David; Jeffrey J Gaynor; John Thompson; Erick Hernandez; Enrique Martinez; G Patricia Cantwell; Jeffrey S Augenstein; Anthony Gyamfi; Ernesto A Pretto; Lorraine Dowdy; Panagiotis Tryphonopoulos; Phillip Ruiz Journal: Ann Surg Date: 2005-10 Impact factor: 12.969
Authors: T Kato; J J Gaynor; S Nishida; N Mittal; G Selvaggi; D Levi; J Moon; J Thompson; P Ruiz; J Madariaga; A G Tzakis Journal: Surg Endosc Date: 2006-03-16 Impact factor: 3.453