Endoscopic monitoring in small bowel transplantation

To investigate the role of endoscopic monitoring in small bowel transplantation.

This study was conducted in two parts-an initial experimental study followed by a clinical study. In the experimental study, segmental small bowel allotransplantation was performed on white outbred pigs. Stomas were created for exteriorization of the proximal and distal ends of the intestines (Thiry-Vella loop). The grafts were monitored by endoscopy via stomas, with or without immunosuppressive therapy. For the clinical study, the whole small-bowel allograft of a woman with short bowel syndrome was endoscopically monitored via distal stoma.

The most common endoscopic findings of graft rejection following small bowel allotransplantation were mucosal erythema, erosion, and ulceration. Diffuse ulceration with bleeding occurred in the late phase of rejection.

Endoscopic monitoring is essential to small bowel transplantation.