Related Experiment Videos
Isolated intestinal transplantation for intestinal failure.
D L Sudan1, S S Kaufman, B W Shaw
1Department of Surgery, University of Nebraska Medical Center, Omaha 68198-3285, USA.
The American Journal of Gastroenterology
|July 14, 2000
Summary
Intestinal transplantation offers a lifesaving option for patients with intestinal failure, showing comparable survival rates to parenteral nutrition. However, improved immunosuppression is crucial to reduce graft loss from rejection.
Area of Science:
- Gastroenterology
- Transplant Surgery
- Immunology
Background:
- Parenteral nutrition is essential for patients with intestinal failure.
- Life-threatening complications can arise from parenteral nutrition.
- Intestinal transplantation serves as a potentially lifesaving intervention for select patients.
Purpose of the Study:
- To evaluate patient and graft survival rates after isolated small bowel transplantation.
- To identify causes of graft loss and complications.
- To assess the reversibility of pre-existing liver dysfunction.
Main Methods:
- Retrospective review of 28 consecutive isolated small bowel transplants.
- Data collected from adult and pediatric patients between December 1993 and June 1998.
- Analysis of patient and graft survival, causes of graft loss, and complication rates.
Main Results:
- One-year patient survival was 93%, and graft survival was 71%.
- Acute rejection was the primary cause of graft loss (5/28), occurring in all patients.
- Preoperative jaundice and hepatic fibrosis were reversed in patients with functional grafts; 11% developed post-transplant lymphoproliferative disease.
Conclusions:
- Intestinal transplantation survival is comparable to parenteral nutrition for intestinal failure.
- Enhanced immunosuppressive strategies are needed to minimize acute rejection and graft loss.
- Post-transplant lymphoproliferative disorder incidence is higher than in other solid organ transplants; cytomegalovirus enteritis risk is low with seronegative donors.