Metabolic, coagulative, and hemodynamic changes during intestinal transplant: good predictors of postoperative damage?

Transplantation. 2007 Aug 15;84(3):346-50. doi: 10.1097/


Background: Analysis of intraoperative changes of metabolic, hemodynamic, and coagulative parameters is useful to detect early ischemia-reperfusion damage after intestinal transplant.

Methods: The objective of our study is to correlate the histological damage at the end of transplant in relation to the intraoperative changes after reperfusion. The histological aspect was graded according to Park's classification at the end of the surgical procedure with biopsies of the graft. Patients were divided into two groups according to the presence or absence of histological damage of the small bowel wall: group A (normal mucosa/minimal damage: Park's grades 0-1) and group B (mucosal damage: Park's grades 2-8).

Results: Significant hemodynamic, metabolic, and coagulative disorders were observed in group B. Consequently, these disorders are thought to be early indicators of graft damage.

Conclusions: Actual monitoring procedures used for postoperative graft surveillance remain paramount in detecting postoperative intestinal dysfunction, but the indicators described in this paper could represent a further help in intraoperative and postoperative management.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Blood Coagulation / physiology
  • Blood Pressure / physiology
  • Cold Temperature
  • Female
  • Graft Survival / physiology
  • Heart Rate / physiology
  • Humans
  • Intestinal Mucosa / metabolism
  • Intestines / pathology
  • Intestines / transplantation*
  • Male
  • Organ Preservation / adverse effects*
  • Organ Preservation / methods
  • Organ Transplantation / adverse effects*
  • Organ Transplantation / pathology
  • Organ Transplantation / physiology
  • Postoperative Period
  • Predictive Value of Tests
  • Reperfusion Injury / diagnosis
  • Reperfusion Injury / metabolism*
  • Reperfusion Injury / physiopathology*
  • Treatment Outcome