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The influence of uremia and immunosuppression on an animal model for ischemic colitis
Authors:Leonard G. Gomella M.D.  Robert C. Flanigan M.D.  Dr. Patrick F. Hagihara M.D.  Bruce A. Lucas M.D.  J. William McRoberts M.D.
Affiliation:(1) Veterans Administration Medical Centers, Lexington, Kentucky;(2) Department of Surgery, Division of General Surgery, University of Kentucky Medical Center, 800 Rose Street, 40536-0084 Lexington, Kentucky
Abstract:Up to 1 percent of renal transplant recipients have been reported to develop ischemic colitis. Immunosuppressive agents and uremia have been implicated in the development of this complication, but their exact relationship remains unclear. A rat model was developed to determine the effects of uremia alone and in combination with immunosuppression on the development of ischemic colitis. Seventy-six animals were included in the study. Uremia and ischemic colitis were induced surgically. The immunosuppressive agents azathioprine and methylprednisolone were administered for 72 hours after a colonic segment was devascularized in chronically uremic rats. One-way analysis of variance (ANOVA) showed that uremia potentiates colonic ischemia significantly (4.09 cm2 vs 1.25 cm2,P<0.03). The addition of parenteral steroids (methylprednisolone) or azathioprine alone and in combination did not potentiate or reduce this ischemic process in uremic animals. Each of these factors alone is commonly present in the renal transplant population and can contribute to the development of potentially fatal ischemic colitis. Supported by Biomedical Research Support Grant RR 05374 from the Division of Research Facilities and Resources, National Institutes of Health, Washington, D.C.
Keywords:Immunosuppressive agents  Uremia  Ischemic colitis  Renal transplantation complications
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