Extrinsic Reinnervation and Extrinsic Nerve Preservation on Intestinal Transplantation in Rats

Hidenori Kiyochi, Atsumi Ono, Kazutomi Miyagi, Naritaka Yamamoto, Katsuyuki Ohnishi, Yasuyuki Shimahara, Nobuaki Kobayashi

First Department of Surgery, Ehime University School of Medicine

Extrinsic denervation is inevitable after a conventional intestinal transplantation procedure and leads to poor intestinal function. In this study, reinnervation by extrinsic sympathetic nerves was investigated in rats morphologically by a glyoxylic acid fluorescence histochemical method. Further, a new intestinal transplantation procedure, in which extrinsic sympathetic nerves are preserved and transplanted with the intestinal graft, was developed. Reinnervation began in the arterial anastomosis 3 weeks after transplantation and extended from proximal to distal following the course of the mesenteric arteries. Reinnervation by fairly dense sympathetic nerve fibers, about 70 to 80% of the control, was found up to the distal portion of the mesenteric arteries 1 year after transplantation. However, in the intestinal wall itself, although reinnervation began 15 weeks after transplantation, the density of reinnervating fibers was rather low even 1 year after transplantation. These results indicate that innervation of the intestinal wall, which plays an important role in graft function, remained poor, while sufficient reinnervation of the mesenteric arteries took place. In contrast, in our new experimental method, in which sympathetic postganglionic nerves remain attached to the intestinal graft, about 75 to 90% of control sympathetic nerve fibers were preserved and transplanted in the mesenteric arteries 3 weeks after transplantation and the innervation of arteries in the intestinal wall was almost identical to the control level from 1 week after transplantation. Recovery of the sympathetic function may be achieved early on, if the grafted sympathetic nerves become appropriately connected to the recipient's nervous system.

Key words
intestinal transplantation, extrinsic nerve reinnervation, extrinsic nerve preservation

Reprint requests
Hidenori Kiyochi First Department of Surgery, Ehime University School of Medicine
Shitsukawa, Shigenobu-cho, Onsen-gun, Ehime, 791-02 JAPAN

Accepted
December 6, 1995

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