Transplantation of small bowel alone or with the liver in pigs: use of peripheral blood lymphocytes in monitoring rejection.

The small bowel is an organ with a large lymphoid component. In addition to the organized structures of the Peyer's patches and mesenteric lymph nodes, the lamina propria also contains a vast mass of mobile lymphocytes. The transplantation of the small bowel has thus been associated with significant rejection phenomena and the possibility of graft-versus-host disease (GVHD) in the recipient, despite the immunosuppressive treatment. In a swine model, we have compared by mixed lymphocyte reaction (MLR) the immunological events occurring during orthotopic liver-small bowel transplantation (OLSBTx) and small bowel transplantation alone (SBTx) to evaluate a possible immunological advantage of combined liver-small bowel transplantation in order to prevent intestinal rejection.