Preclinical experimental studies showed that shock or trauma cause gut barrier failure and bacteria translocating to distant organs. Also, the subsequent gut released pro- inflammatory and tissue injurious factors could result in acute lung injury, bone marrow failure, myocardial dys- function, neutrophil activation, red blood cells injury and endothelial cell activation and injury. Interestingly, these factors are carried in the mesenteric lymphatics, but not in the portal blood flow and are sufficient to cause MODS [31].