Intestinal transplantation for the treatment of neoplastic disease

Authors reviewed single center experience of intestinal transplantation for treatment of intra-abdominal neoplastic disease.

There were 25 auto- or allograft transplantations in 21 patients; desmoid tumor (14), neuroendocrine tumor (2), adenocarcinoma (2), hemangioma (1), lymphoma (1), and solid pseudopapillary tumor (1). Medical records were reviewed for cause of graft loss and mortality, recurrent neoplasm, and quality of life. Survival was analyzed using Kaplan-Meier method.

There were 11 graft losses; mortality with functioning graft (6), ischemic necrosis (2), acute or chronic rejection (2), and arterial thrombosis (1) during 38 months of mean follow-up. Seven patients died because of recurrent neoplasm and transplant related complications. Six patients experienced recurrent disease; three desmoid tumor (3/14), two adenocarcinoma (2/2), and one neuroendocrine tumor (1/2). Recurrent desmoid tumors were successfully treated with simple excision. Patient and graft survival in the desmoid tumor are 69.2% and 50.0% at 5 years after transplant. Among 14 survivors, 2 need parenteral nutrition or intravenous hydration. Twelve patients are working full time.

Intestinal transplantation is a reasonable life-saving treatment for catastrophic intra-abdominal neoplastic diseases.