RECONSTRUCTION OF THE INTESTINAL LYMPHATIC DRAINAGE AFTER SMALL BOWEL TRANSPLANTATION 1
Bibliographic record
Abstract
BACKGROUND: The surgical procedure of small bowel transplantation normally results in complete disruption of the graft's lymphatic drainage. The present study was undertaken to determine the impact of lymphatic reconstruction (LR) on the outcome of intestinal grafting, using a microsurgical model that immediately restores lymphatic drainage. MATERIALS: Brown Norway (RT1n) intestinal grafts were orthotopically transplanted into Lewis (RT1(1)) rats either with LR (+LR) or without LR (-LR). Recipients were randomly allocated into the following groups: no treatment or cyclosporine (CsA) at a dose of 2, 5, or 10 mg/kg/day subcutaneously from postoperative day (POD) 0 to 6. RESULTS: There was morphological regeneration of lymphatics in the -LR group between 1-3 weeks as previously reported, whereas normal lymph flow was immediately restored in the +LR group. All untreated and CsA(2 mg)-treated allografts were rapidly rejected in both the +LR and -LR groups. In the groups treated with approximately 5 mg of CsA, five of six -LR animals died of chronic rejection between 38 and 86 days (mean survival time +/- SD: 76.7+/-21 days), while all +LR animals survived until death on POD 100 (P < 0.05). Histological features of mucosal damage found in -LR grafts were absent in the +LR grafts. All of the animals treated with 10 mg of CsA survived indefinitely. Sequential histology revealed mild rejection in -LR and +LR grafts on POD 45, but +LR animals had significantly higher body weight gains (POD 50: -LR: 117+/-12% vs. +LR: 136+/-4%, P < 0.01). LR did not affect donor cell migration and nutritional parameters. CONCLUSION: LR improves the long-term results of small bowel transplantation resulting in better survival rates, less mucosal damage due to chronic graft rejection, and greater weight gain. We conclude that impairment of lymph flow may contribute to poor outcomes when standard surgical techniques are used for small bowel transplantation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".