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Small bowel transplantation.

K R Prasad1, S G Pollard

  • 1Department of Organ Transplantation, St. James's University Hospital, Leeds, United Kingdom.

Current Opinion in Gastroenterology
|October 7, 2006
PubMed
Summary
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Small bowel transplantation offers a life-saving option for patients with intestinal failure. Advances in immunosuppression and prophylaxis have improved outcomes, though sepsis and rejection remain challenges.

Area of Science:

  • Gastroenterology and Transplant Surgery
  • Immunology

Background:

  • Small bowel transplantation (SBT) development faced significant immunological and infectious hurdles.
  • Recent progress achieved with tacrolimus and improved anti-infection prophylaxis.

Purpose of the Study:

  • To review the current status of small bowel transplantation.
  • To discuss challenges and future directions in the field.

Main Methods:

  • Review of current literature and clinical practices in small bowel transplantation.
  • Analysis of outcomes, complications, and emerging strategies.

Main Results:

  • SBT is a life-saving option for patients with intestinal failure and liver failure.
  • Common causes of mortality and graft loss include sepsis, rejection, and lymphomas.

Related Experiment Videos

  • Surgical techniques are standardized, with grafts performed as intestine-only or composite grafts.

    • Conclusions:

    • Further progress requires enhanced immunosuppressive and immunomodulatory strategies.
    • The role of chimerism induction via bone marrow transfusions for tolerance is uncertain.
    • SBT remains a salvage procedure for total parenteral nutrition failure, not a primary treatment for intestinal failure.