En bloc transplantation of the liver, pancreas, duodenum, spleen, and kidney in the rat.

Five organs consisting of the liver, pancreas, duodenum, spleen, and kidney from (Lewis X Brown Norway)F1 rats were transplanted simultaneously as an en bloc graft to Lewis recipients. No immunosuppression was given postoperatively. Serial laporatomies were performed for macroscopic examination and biopsies of the grafts. Macroscopically, the first evidence of rejection was splenic enlargement followed by fatty metamorphotic change of the liver, dilation and loss of peristalsis of the duodenum, and injection of the pancreas. The kidney maintained normal color and consistency until late in the rejection process. Histological examination suggested that the liver and the spleen may be more vulnerable to immune attack, since in these organs cellular infiltration started earlier and was more extensive in comparison to other organs. While the pancreas exhibited a typical, although somewhat delayed rejection pattern, the kidney seemed to maintain a well preserved structure. Interestingly, the duodenum showed no significant cellular infiltration throughout the postoperative period of examination despite severe mucosal destruction.