Microsurgical Technique and Results of Anorectal Transplantation in the Rat

Anorectal transplantation (ART) is an obvious therapeutic option for treating permanent colostomy and severe fecal incontinence. The rat is the best model for beginning studies of a new surgical procedure. In this article, we review ART techniques in rats. Methods. We reviewed articles on rat and ART keywords throughout Cochrane Library, MEDLINE, and EMBASE. Five articles were found, of which 2 used autotransplantations, 1 performed only transplantation of the anal canal and extraperitoneal rectum, and another performed transplantation of the entire intestine, including the anus, but only followed for 2 hours. Results. In 2016, we performed the fi rst series of isoART (n = 6) and alloART (n = 9) of the entire anorectal segment and micro-anastomosis of the inferior mesenteric vessels. Two animals died due to surgical complications, and the others survived until the endpoint of the experiment. Five animals with alloART showed clinical signs of immunologic rejection 3 weeks after transplantation, and autopsy histology on postoperative day 30 revealed moderate to severe rejection in the allografts. Conclusions. In this review, we observed that ART in rats is viable and may allow further physiologic and immunologic studies of this procedure, a potential treatment for severe incontinence and permanent colostomy.