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Monitoring of the intestinal mucosal perfusion using laser Doppler flowmetry after multivisceral transplantation

Oltean, Mihai, 1976 (author)
Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för kirurgi,Institute of Surgical Sciences, Department of Surgery
Åneman, Anders, 1965 (author)
Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för anestesiologi och intensivvård,Institute of Surgical Sciences, Department of Anaesthesiology and Intensive Care
Dindelegan, G. (author)
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Molne, J. (author)
Olausson, Michael, 1956 (author)
Gothenburg University,Göteborgs universitet,Institutionen för de kirurgiska disciplinerna, Avdelningen för kirurgi,Institute of Surgical Sciences, Department of Surgery
Herlenius, Gustaf, 1961 (author)
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 (creator_code:org_t)
2005
2005
English.
In: Transplantation proceedings. - 0041-1345. ; 37:8, s. 3323-4
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • BACKGROUND: Graft endothelium constitutes a prime target during acute rejection. Infiltration of T cells, monocytes, and enhanced endothelial-leukocyte interactions result in microvascular impairment and altered perfusion. MATERIALS AND METHODS: We measured mucosal blood flow using a laser Doppler flowmeter in three patients undergoing multivisceral transplantation. Thirty-seven measurements were performed through the ileostomy over the first 4 weeks posttransplantation. Most measurements were performed within a 24-hour interval from endoscopy and biopsy. RESULTS: Mucosal perfusion increased throughout the first postoperative week and eventually stabilized around levels specific for each patient. Mucosal perfusion remained stable during graft pancreatitis, but decreased 35% to 55% from baseline (the average value of the previous measurements) during acute rejection and sepsis. During the first week posttransplantation there was a gradual increase in mucosal perfusion, which might reflect regeneration after reperfusion injury. Increased mucosal perfusion did not seem to correlate with rejection or other adverse clinical events. A sudden decrease in mucosal perfusion of 30% or more compared to the previous measurements was associated with septic episodes and/or rejection.

Keyword

Adult
Aged
Female
Graft Rejection
Humans
Ileostomy
Intestinal Mucosa/*blood supply/*ultrasonography
Intestines/*transplantation
Laser-Doppler Flowmetry/methods
Middle Aged
Monitoring
Physiologic
Postoperative Period
Regional Blood Flow

Publication and Content Type

ref (subject category)
art (subject category)

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