The effects of size and site of origin of intestinal grafts on small-bowel transplantation in the rat.

This study was initiated to evaluate the effects of varying the length and site of origin of small-intestine transplants on rejection and on graft-versus-host disease (GVHD). Eighty rats had heterotopic transplants performed with systemic venous drainage of the grafts. The host native bowel was left in situ and no immunosuppressive agents were used. Twenty male Lewis inbred (LEW) rats who received isogenic grafts survived without any evidence of rejection or GVHD. When intestine from Lewis X Brown Norway hybrid rats (LBN) was transplanted into LEW rats, rejection occurred between day 6 and 9 and the time of onset of rejection was not influenced either by the length of transplanted bowel (10 to 80 cm, n = 6 each) or by whether the graft was from the jejunum or the ileum. However, rates of survival for 100 days from rejection were significantly better if 10 cm (100%) or 20 cm (84%) was transplanted than if the grafts were 40 cm or more in length (56%). The LBN recipients of LEW allografts developed GVHD on days 7 through 9, and this response was similarly unrelated to the length or segment of bowel transplanted. However, host survival was quite dependent on graft segment length and site of origin. All animals who received 20 cm or less of proximal bowel survived (with GVHD but no evidence of rejection). While 50% of the animals that received proximal intestinal grafts 40 cm in length survived GVHD, none who received identical-sized grafts from the distal ileum survived (all were dead by day 20). Our data document that the results of small-intestine transplantation is dependent on the length and site of origin of the grafts.