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Autologous-allotopic ileum mucosa transplantation for small bowel elongation. A morphological study

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Abstract

Introduction

Since a standard therapy for short bowel syndrome does not yet exist, every search for new surgical methods would be worthwhile. In previous studies we could show that autologous-allotopic ileum mucosa transplantation is feasible. After a modification of our technique a vascularized colon muscle coat lined completely with transplanted ileum mucosa could be engendered.

Method

In 12 young beagles autologous ileum mucosa was transplanted in a demucosed vascularized transverse colon segment. The colon coat-ileum mucosa complex was anastomosed with the small bowel immediately after transplantation, 4 weeks later the animals were sacrificed and histology specimens were harvested from the colon coat-ileum mucosa complex, normal ileum and normal colon. After fixation in 2.5% glutaraldehyde the samples were frozen (−40°C) and 14 µm sections were stained with hemalaun and eosin. The lumen diameter, the mucosa, submucosa and colon muscle coat thickness, as well as the mucosal crypt depth were evaluated.

Results

The diameter of the colon coat-ileum mucosa-complex was smaller than the diameter of normal ileum and colon with no significant stenosis. There were no marked differences in thickness of mucosa and depth of the mucosal crypts compared to the controls, but the transplanted mucosa showed a slightly higher rate of shortened villi. The submucosal layer was thicker following transplantation and showed good neovascularization. The circular muscle layer of the transplanted colon coat was up to 178% thicker and the thickness of the transplanted longitudinal muscle layer differed between 58% and 143% in comparison to normal colon.

Conclusions

Only a few histologic differences between transplanted and normal ileum mucosa could be observed after autologous-allotopic ileum mucosa transplantation. Therefore a nearly normal function of the colon coat-ileum mucosa complex has to be expected. Long term experiments of the histologic changes as well as further functional studies are on-going in order to finally apply autologous-allotopic ileum mucosa transplantation clinically.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Ruprecht-Karls-University, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany

    Hans Albert Beiler, Alexander Witt, Jörn Steinorth & Zacharias Zachariou

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  1. Hans Albert Beiler
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  2. Alexander Witt
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  3. Jörn Steinorth
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  4. Zacharias Zachariou
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Correspondence to Hans Albert Beiler.

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Beiler, H.A., Witt, A., Steinorth, J. et al. Autologous-allotopic ileum mucosa transplantation for small bowel elongation. A morphological study. Ped Surgery Int 20, 91–95 (2004). https://doi.org/10.1007/s00383-003-1094-2

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