Preservation injury has been a relatively minor problem in small bowel transplantation. In part, this is likely a result of the intestine's great capacity for epithelial regeneration. Usually changes of preservation injury are noted during the first few days following transplantation, but resolve within a week post-transplant. Histologically these changes encompass a range of alterations that affect the superficial mucosa, primarily the villi with a variable inflammatory contribution. In pretransplantation specimens, the surface epithelium may be detached from the underlying edematous lamina propria but usually with no active inflammatory infiltration. Shortly after reperfusion, the epithelium often show pronounced regenerative changes of crypt epithelium characterized by conspicuous mitosis, capillary congestion and shortening of villi with variable degrees of neutrophil-rich inflammatory infiltration. Normal histology is usually present within a week after transplantation.
Lee RG, Nakamura K, Tsamandas AC, Abu-Elmagd K, Furukawa H, Hutson WR, Reyes J, Tabasco-Minguillan JS, Todo S, Demetris AJ. Pathology of human intestinal transplantation. Gastroenterology 1996;110:1820-1834.
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