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Intestinal and multivisceral transplantation.
Jang Il Moon1, Andreas G Tzakis
1Division of Liver and GI Transplant, Department of Surgery, University of Miami School of Medicine, Miami, FL 33136, USA. jmoon@med.miami.edu
Yonsei Medical Journal
|January 1, 2005
Summary
Intestinal transplantation offers a life-saving option for intestinal failure, with over 1,000 global cases performed. Ongoing advancements in surgical techniques and immunosuppression improve outcomes, though rejection and infection remain challenges.
Area of Science:
- Gastroenterology and Hepatology
- Transplant Surgery
- Immunology
Background:
- Intestinal transplantation is a viable treatment for intestinal failure and complications from total parenteral nutrition.
- The field has seen rapid evolution, surpassing 1,000 worldwide cases.
- Intestinal allografts are transplanted as isolated, combined with liver, or as part of multivisceral grafts.
Purpose of the Study:
- To review the current status and outcomes of intestinal transplantation.
- To highlight advancements in surgical techniques and immunosuppression.
- To identify persistent challenges in patient and graft survival.
Main Methods:
- Review of clinical outcomes and established protocols in intestinal transplantation.
- Analysis of immunosuppression strategies, particularly tacrolimus-based regimens.
- Examination of factors influencing patient and graft survival.
Main Results:
- Tacrolimus-based immunosuppression is standard and associated with improved outcomes.
- Significant improvements in clinical outcomes have been observed over time.
- Rejection, infection, and technical complications are key barriers to survival.
Conclusions:
- Intestinal transplantation has evolved into a significant treatment modality.
- Refined surgical techniques and immunosuppression have enhanced clinical outcomes.
- Addressing rejection, infection, and technical issues is crucial for future progress.