[Small bowel transplantation as an experimental and clinical replacement procedure]

Small bowel transplantation as an experimental and clinical replacement procedure. The routine use of human small bowel isografts as a treatment for mucosal defects, e. g. in the hypopharynx, demonstrates clearly that early surgical problems with this procedure have almost been solved. However, human small bowel allografts show a high risk for complications after transplantation. They provoke severe rejection episodes in the recipients which have to be treated with high-dose immunosuppression. These rejection episodes are of major interest for our own experimental research in rats: Video-microscopy (clinically established as zoom-endoscopy) makes early recognition and immediate therapy of these events possible. Concommittant liver transplantation from the identical donor even eliminate them. However, further research of the specific small bowel immune system is needed, to make this organ transplantation even clinically more successful.