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Göteborgs universitets publikationer

Laser-Doppler flowmetry in the monitoring of the human intestinal allograft: a preliminary report.

Författare och institution:
Mihai Oltean (Institutionen för kliniska vetenskaper, sektionen för kirurgi och kirurgisk gastroforskning); Gustaf Herlenius (Institutionen för kliniska vetenskaper, sektionen för kirurgi och kirurgisk gastroforskning); G. Dindelegan (-); Markus Gäbel (Institutionen för kliniska vetenskaper, sektionen för kirurgi och kirurgisk gastroforskning); Johan Mölne (Institutionen för biomedicin, avdelningen för patologi); Ola Nilsson (Institutionen för biomedicin, avdelningen för patologi); Anders Åneman (Institutionen för kliniska vetenskaper, sektionen för anestesi, biomaterial och ortopedi); Michael Olausson (Institutionen för kliniska vetenskaper, sektionen för kirurgi och kirurgisk gastroforskning)
Publicerad i:
Transplantation proceedings, 38 ( 6 ) s. 1723-5
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
During acute rejection, graft endothelium becomes a prime target for recipient immune cells. Animal studies have shown reduced microvascular perfusion, probably due to increased endothelial-leukocyte interaction and endothelial impairment, leading to graft damage. Using laser-Doppler flowmetry (LDF), we correlated the microvascular blood flow in the intestinal mucosa of five patients receiving multivisceral grafts with clinical events and pathology results. Measurements (n = 75) were performed during the first 4 weeks posttransplantation by inserting the LDF flexible probe through the ileostomy for 25 to 30 cm. Forty-six of the 75 measurements were performed within 24 hours of endoscopy and biopsy. In uncomplicated cases, we recorded a gradual increase in mucosal perfusion during the first week posttransplantation that presumably reflected regeneration after reperfusion injury. Increased mucosal perfusion did not seem to correlate with rejection or other adverse clinical events. Sudden and sustained decreases in mucosal perfusion by 30% or more compared to the previous measurements were associated with septic episodes, rejection, or both. LDF revealed a good sensitivity in monitoring the intestinal microcirculation. It was able to indicate perfusion changes associated with acute rejection. The relatively low specificity of LDF may be compensated by the low invasivity, allowing frequent investigation. LDF may be an additional tool for routine monitoring of intestinal allografts.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Adult, Female, Graft Rejection, Humans, Intestinal Mucosa, blood supply, Intestines, transplantation, Laser-Doppler Flowmetry, Male, Microcirculation, ultrasonography, Middle Aged, Monitoring, Physiologic, Transplantation, Homologous, physiology, Treatment Outcome, Viscera, transplantation
Postens nummer:
Posten skapad:
2007-10-05 11:25
Posten ändrad:
2012-02-28 12:07

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