Postoperative enteral feeding improves mucosal morphometry and absorption of d-xylose by intestinal allografts in pigs

Intestinal absorption of nutrients has been reported as considerably reduced after total orthotopic small bowel transplantation (TOSBT) in pigs as well as in humans; moreover, morphological changes of mucosal structure are commonly found in intestinal allografts, even when immunological factors such as acute or chronic graft rejection or graft-versus-host disease (GVHD) are not detectable. In the clinical setting, the common policy to limit these adverse effects of TOSBT is to start an enteral feeding as soon as possible after surgery, but this impact has never been validated by controlled trials. Therefore, the aim of this study was to assess the intestinal absorption of d-xylose and the changes in villi height in pigs given either a commercial chow ad libitum or a polymeric enteral formula after TOSBT under Cyclosporin A (CyA).