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Adult Intestinal Transplantation
Cal S Matsumoto1, Sukanya Subramanian1, Thomas M Fishbein1
1Medstar Georgetown University Hospital, Medstar Georgetown Transplant Institute, 3800 Reservoir Road, Northwest, 2 PHC Building, Washington, DC 20007, USA.
Gastroenterology Clinics of North America
|May 9, 2018
Summary
Adult intestinal transplantation has evolved, with expanded indications and improved outcomes. Colonic inclusion in grafts now shows superior survival and quality of life for patients with intestinal failure.
Area of Science:
- Gastroenterology and Hepatology
- Transplant Surgery
- Immunology
Background:
- Adult intestinal transplantation (AIT) presents unique challenges compared to pediatric cases.
- Indications for AIT have broadened beyond traditional intestinal failure to include motility disorders and desmoid tumors.
- Graft selection in AIT is tailored to adult recipient anatomy.
Purpose of the Study:
- To review the evolution and current status of adult intestinal transplantation.
- To analyze changes in indications, graft types, and outcomes over the past two decades.
- To highlight the increasing role and benefits of colonic inclusion in adult intestinal grafts.
Main Methods:
- Retrospective analysis of adult intestinal transplantation data from 2000 to present.
- Review of patient demographics, indications for transplant, graft composition, and post-transplant outcomes.
- Comparative analysis of outcomes with and without colonic inclusion in adult intestinal grafts.
Main Results:
- Indications for AIT have expanded, notably to include motility disorders and desmoid tumors.
- Graft survival and patient quality of life have improved with the increasing use of colonic inclusion.
- Overall outcomes in adult intestinal transplantation have shown steady improvement.
Conclusions:
- Adult intestinal transplantation is a vital therapy for complex intestinal failure.
- It offers a promising solution for life-threatening conditions previously untreatable.
- The inclusion of the colon in adult intestinal grafts is associated with favorable outcomes and improved patient well-being.
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