Growth hormone improves graft mucosal structure and recipient protein metaboli sm in rat small bowel transplantation

OBJECTIVE: To observe the effects of recombinant human growth hormone (rhGH) on graft structure and recipient protein metabolism in rat small bowel transplantation (SBT) and total parenteral nutrition (TPN) models. METHODS: Twenty recipients of rat allogeneic heterotopic small bowel transplants (SD-->Wistar) were divided into two groups (GH group and control group). Both groups were supported by standard TPN. Acute rejection was suppressed with CsA 10 mg x kg(-1) x d(-1) intramuscularly. All rats in the experimental group received subcutaneous rhGH 1 U x kg(-1) x d(-1) after transplantation. Morphological mucosal indices of transplanted gut and metabolic parameters such as body weight, nitrogen balance, urinary 3-methyl histidine excretion and serum albumin of the recipients were compared between two groups. RESULTS: The application of rhGH promoted graft recovery significantly compared with standard TPN support alone. On postoperative day 14, all morphological indexes of transplanted gut recovered to the preoperative state. Protein metabolism in the recipient was also significantly improved. rhGH decreased the catabolism of protein, accelerated regaining of positive nitrogen balance and corrected hypoalbuminemia. CONCLUSION: GH is an effective metabolic intervention in SBT. It may promote the structural repair of the graft and correct the metabolic disturbance. It is useful in improving the outcome of clinical SBT.