Esophageal transplantation in the rat ☆,☆☆,★ Ibrahim Uygun a, ⁎ , Mehmet Hanifi Okur a , Bahattin Aydogdu a , Selver Ozekinci b , Selcuk Otcu a a Department of Pediatric Surgery and Pediatric Urology, Medical Faculty of Dicle University, 21280 Diyarbakir, Turkey b Department of Pathology, Medical Faculty of Dicle University, 21280 Diyarbakir, Turkey Received 16 August 2012; revised 2 October 2012; accepted 3 October 2012 Key words: Esophageal transplantation; Esophagus; Transplantation Abstract Purpose: Esophageal replacement surgery has been used to treat long-gap esophageal atresia, caustic esophageal stricture, and esophageal avulsion. Here, we report total esophageal transplantation in rats without vascular anastomosis as an option for esophageal replacement surgery. Methods: Fourteen total segments of esophageal transplants were harvested from 24-week-old male Sprague–Dawley rats using a harvesting procedure. The segments were transplanted through the mediastinum in the esophageal bed of 15-week-old male Sprague–Dawley rats without adjacent vascular anastomosis using the transhiatal pull-up technique. The ends of the transplanted esophagus were ostomized using cervical and abdominal esophagostomies. An immunosuppressive-treated (IT) group (n = 7) received cyclosporine and cotrimoxazole for 10 days, while an untreated (UT) group (n = 7) received only cotrimoxazole for 10 days. On post-operative day 10, the rats were sacrificed, and the transplant and recipient esophagi were evaluated macroscopically and histopathologically. Results: All transplantations were successful and all transplanted rats survived. Upon macroscopic evaluation, no evidence of complications was observed and all transplanted esophagi in the two groups appeared to exhibit excellent firm tissue; however, mild necrosis was observed in the cervical end of the transplant in one rat in the IT group. Histopathologic examination showed a viable esophageal structure in all rats. Inflammation and muscular atrophy were lower in the IT group than in the UT group, whereas vascularity was higher in the IT group than in the UT group. Conclusion: Total esophageal transplantation was performed directly without vascular anastomosis into recipients in a rat model. This procedure should be done in larger animal models before being attempted in humans. © 2013 Elsevier Inc. All rights reserved. Esophageal replacement surgery has been used to treat long-gap esophageal atresia, caustic esophageal stricture, esophageal avulsion, and esophageal cancer using digestive organs such as the colon, stomach, ileum, or jejunum. However, esophageal replacement surgery still presents a major challenge and is associated with complications, mortality, and significant morbidity [1–4]. Experimental esophagus tissue engineering and esophageal transplantation studies are promising for this type of surgery [5–7]. ☆ Financial Disclosure: The authors have indicated they have no financial relationships relevant to this article to disclosure. ☆☆ Disclosure Statement: The authors declare that they have no conflicts of interest. ★ The English in this document has been checked by at least two professional editors, both native speakers of English. For a certificate, please see: http://www.textcheck.com/certificate/dIJUn0. ⁎ Corresponding author. Tel.: +90 412 248 8001, +90 505 413 0944 GSM; fax: +90 412 248 8523. E-mail address: iuygun@hotmail.com (I. Uygun). www.elsevier.com/locate/jpedsurg 0022-3468/$ – see front matter © 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jpedsurg.2012.10.001 Journal of Pediatric Surgery (2013) 48, 1670–1675