[L-arginine administration improves mucosal structure in the early phase of reperfusion of small intestine transplants].

L-arginine and molsidomine application prior to reperfusion significantly reduced the preservation and reperfusion-related injury after small bowel transplantation. The architecture of the mucosa was best preserved after treatment with L-arginine and methylprednisolone. The macroscopic appearance of the mucosa was improved (less watery and less thin than after reperfusion of non-treated recipients). The histological appearance was improved. But the most prominent changes were observed by antilaminin staining showing an almost normal architecture of the basement membrane compared with compressed and thickened basement membrane structures in non-treated recipients. This was accompanied by a decrease in CD44-expression within the villi cores and crypts 20 minutes and 24 hours after reperfusion. The release of hyaluronic acid into the plasma was also lower after treatment with L-arginine and molsidomine in combination with methylprednisolone than in non-treated recipients. These improvements may result from increased NO-production by L-arginine which may scavenge superoxid anions. The latter are known intermediates that cause significant injury at the endothelial level and at the extracellular matrix including the basement membrane.