In Vivo Small Bowel Bioengeneering Using Allogenic Aprtoc Grafts in Pigs

Elie K Chouillard, MD, PhD1, Elias Chahine, MD1, Emmanuel Martinod, MD, PhD2. 1PARIS POISSY MEDICAL CENTER, 2Hopital AVICENNE (Bobigny, France)

INTRODUCTION: The ideal treatment of short bowel syndrome remains to be determined. Indicated in severe forms, intestinal transplantation is associated with a 5-years survival rate of only 50%. Parenteral nutrition for life, the most utilized alternative has similar results. We have already used aloogenic arterial segments to replace the upper airway in sheep. The results were encouraging with a transformation of the aortic wall into tracheo-bronchial tissue. In this study, We evaluated the results of a small bowe bioengeneering model using allogenic aortic grafts in pigs.

Materiel & Methods: Seven young minipigs were operated. A 10-cm diameter, allogenic, aortic graft was interposed in the proximal small bowel, wraped with the neighboring omemtum.

Animals were autopsied at at 1 (n = 2), 3 (n = 3), and 6 months (n = 2), respectively. Specimens were evaluated macroscopically and microscopically.

RESULTS: The overall survival rate ofnthe animals was 71.4%. No disruption or leak occured. The small bowel remained patent without stenosis. Histologic analysis revealed intestinal-like wall transformation of the aortic graft in the surviving animals.

CONCLUSION: Aortic-enteric anastomosis is feasible in a pig model. Moreover, in-vivo, bioengeneered, intestinal-like transformation of the vascular wall was disclosed.

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