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Intestinal transplantation in composite visceral grafts or alone
S Todo1, A G Tzakis, K Abu-Elmagd
1Department of Surgery, University of Pittsburgh School of Medicine, Pennsylvania.
Annals of Surgery
|September 1, 1992
Summary
Small bowel transplantation shows promising results, with most patients achieving independence from total parenteral nutrition and supporting growth. Intestine-only transplants offer faster recovery with comparable rejection control.
Area of Science:
- Transplantation immunology
- Gastroenterology
- Surgical innovation
Background:
- Total parenteral nutrition (TPN) is a life-sustaining therapy for patients with intestinal failure.
- Small bowel transplantation (SBT) offers a potential alternative to TPN, but challenges in graft survival and patient management persist.
Purpose of the Study:
- To evaluate the outcomes of small bowel transplantation using FK 506-based immunosuppression.
- To compare the results of intestine-only SBT with combined liver-intestine and multivisceral transplantation.
Main Methods:
- Seventeen patients underwent SBT with FK 506 immunosuppression, receiving either intestine only, intestine-liver, or multivisceral grafts.
- Patients were monitored for graft survival, nutritional status, complications, and rejection episodes.
Main Results:
- Sixteen of 17 patients survived beyond 1 month post-transplant, with 12 achieving independence from TPN.
- Pediatric recipients demonstrated growth and weight gain.
- Intestine-only recipients experienced faster convalescence and similar rejection control compared to combined grafts.
Conclusions:
- Small bowel transplantation is a viable option for intestinal failure, leading to improved nutrition and quality of life.
- Further clinical trials are warranted to optimize management and outcomes.
- Intestine-only SBT may offer advantages in terms of recovery and complication rates.