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Changes in gut function during hibernation: implications for bowel transplantation and surgery
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Organ transplantation has become routine in many centres
throughout the world. Although success rates for intestinal
transplantation are generally lower than for other organs, it is still
high enough to warrant this form of therapy for patients with short
bowel syndrome or other untreatable bowel diseases. Much of the success in transplantation is due to the impact of immunosuppressive drugs as
well as the development of new surgical techniques and new methods of
organ preservation. The intestine has been preserved successfully for
about 24 hours, as judged by in vitro viability assessment1 and by survival after
transplantation.2 However, problems associated with
extended cold storage, ischaemia/reperfusion injury, and immunological
rejection of grafts still limit the optimal use of intestinal
transplantation. The benefit of hypothermic organ preservation is
generally attributed to the reduction in oxygen and nutrient demands
and in the rates of potentially damaging enzyme catalysed reactions.
However, lack of oxygen in
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