Nakada K, Ikoma A, Suzuki T, Reynolds J C, Campbell W L, Todo S, Starzl T E
Department of Surgery, Pittsburgh Transplantation Institute, University of Pittsburgh, School of Medicine.
Am J Surg. 1995 Mar;169(3):294-9. doi: 10.1016/S0002-9610(99)80161-5.
Intestinal dysmotility and stasis after intestinal transplantation are considered to promote bacterial overgrowth and translocation. Two prokinetic agents, KW5139 (13-leu-motilin) and the somatostatin analogue octreotide acetate, were studied to determine whether they can ameliorate intestinal dysmotility during the early postoperative period.
Motility was recorded by multiple extraluminal strain-gauge transducers in 6 dogs on postoperative days 1, 3, 7, and 14. A barium meal study was performed with a separate group of 8 dogs on postoperative days 3 and 7.
The agent KW5139 induced brief, weak contractions in the graft and had little effect on the dilated bowel; however, octreotide induced motor activity that propelled accumulated intestinal contents into the colon and reduced dilation of the transplanted bowel.
Octreotide, but not KW5139, ameliorates intestinal dysmotility associated with bowel autotransplantation during the early postoperative period. Short-term administration of octreotide may be useful for the treatment of dysmotility following intestinal transplantation.
肠道移植后肠道运动障碍和淤滞被认为会促进细菌过度生长和易位。研究了两种促动力剂KW5139(13-亮氨酸-胃动素)和生长抑素类似物醋酸奥曲肽,以确定它们是否能改善术后早期的肠道运动障碍。
在术后第1、3、7和14天,用多个腔外应变片式传感器记录6只犬的肠道运动。在术后第3天和第7天,对另一组8只犬进行了钡餐检查。
药物KW5139在移植物中引起短暂、微弱的收缩,对扩张的肠段影响很小;然而,奥曲肽诱导了运动活性,将积聚的肠内容物推进结肠,并减少了移植肠段的扩张。
奥曲肽而非KW5139可改善术后早期与肠道自体移植相关的肠道运动障碍。短期给予奥曲肽可能有助于治疗肠道移植后的运动障碍。