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EFFECTS OF LOW-MOLECULAR-WEIGHT HEPARINS ON BACTERIAL TRANSLOCATION IN AN EXPERIMENTAL MESENTERIC ISCHEMIA REPERFUSION INJURY MODEL
SELUK KKSAL, NUR AYDIN KAMA, ECE BLR KKSAL, MHRBAN MEK, ONUR ZARI, ZEYNEP MNE YALINKAYA KARA
Hamidiye Medical Journal - 2024;5(3):138-147
Aydn Atatrk State Hospital Clinic of General Surgery, Aydn, Trkiye

Background Low molecular weight heparin (LMWH) has been reported to prevent intestinal bacterial translocation (BT), although this is not certain. The aim of this study was to determine the effect of LMWH used to prevent BT after mesentery ischaemia-reperfusion (I/R). Materials and Methods In this controlled experimental study, 21 female Wistar-Albino rats with an average weight of 250-350 grams were used. The rats were randomly divided equally (n=7) into 3 groups (control group, I/R group and I/R+LMWH group). Control group, no procedure other than explorative laparotomy (Ex-lab.) was performed. I/R group, superior mesenteric artery was clamped for 45 minutes and reperfusion was performed for 60 minutes after Ex-lab. I/R+LMWH group, 1 mg/kg enoxaparin sodium was given to the rats 4 hours before the I/R group. At the end of the experiment, samples taken from the ileum were evaluated histopathologically. The number of microorganisms per gram of tissue was analysed in blood, mesenteric lymph node (MLN), spleen and liver samples. Serum nitric oxide (NO) levels were also measured. RESULTS When the groups were evaluated histopathologically in terms of ileal tissue damage, the difference between I/R and I/R+LMWH groups was found to be statistically insignificant (p=0.318). However, BT levels in tissue cultures of I/R+LMWH group were significantly decreased compared to I/R group (39% vs. 75%, p<0.001). There was no statistical difference between the bacterial counts per gram of total tissue of MLN, spleen and liver tissues of I/R and I/R+LMWH groups (4458.37 vs. 3157.14 colony-forming units/g, respectively, p=0.101). Although there was no statistical difference between them, NO levels in I/R+LMWH group tended to be higher than control and I/R groups [295 (149-437), 165 (89-298) and 192 (80-263) pg/mL; p=0.0626]. CONCLUSION Since LMWH decreased BT and increased NO levels in patients with mesenteric ischaemia, it was determined that LMWH could be used as a therapeutic option to prevent sepsis.

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