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Small bowel transplantation.

A Ghanekar1, D Grant

  • 1Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

Current Opinion in Critical Care
|May 25, 2001
PubMed
Summary

Small bowel transplantation is a key treatment for chronic gut failure, offering improved outcomes with advancements in surgical care and rejection management. Despite challenges like rejection and sepsis, successful recipients can resume normal diets.

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Area of Science:

  • Gastroenterology
  • Transplantation Surgery
  • Immunology

Background:

  • Small bowel transplantation is the primary treatment for chronic gut failure unresponsive to home parenteral nutrition.
  • Improvements in patient selection, surgical techniques, and immunosuppression have enhanced outcomes.
  • Early organ donor listing is crucial due to donor organ scarcity.

Purpose of the Study:

  • To review the current state of small bowel transplantation.
  • To highlight advancements in managing graft rejection and patient outcomes.
  • To discuss the challenges and successes of this complex procedure.

Main Methods:

  • Review of current literature and clinical practices in small bowel transplantation.
  • Analysis of outcomes related to patient selection, surgical techniques, and immunosuppressive therapies.
  • Examination of complication rates, including graft rejection and sepsis.

Main Results:

  • Rejection rates remain high, exceeding 50%, even with potent immunosuppression.
  • Sepsis rates are elevated post-transplant due to bacterial translocation.
  • Graft and patient survival rates are comparable to lung transplantation outcomes.
  • Successful recipients achieve unrestricted oral diets.

Conclusions:

  • Small bowel transplantation is a viable option for select patients with chronic gut failure.
  • Ongoing research is needed to further reduce rejection and sepsis rates.
  • Successful transplantation significantly improves quality of life by enabling oral nutrition.

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