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Updated: Aug 11, 2025
Orthotopic Small Bowel Transplantation in Rats
Published on: November 6, 2012
Potential for intestinal transplantation after acute mesenteric ischemia in patients aged less than 70 years: A
Aurora Lemma1, Sampsa Pikkarainen2, Anne Pohju3
1Department of Abdominal Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Background And Objective:
Acute mesenteric ischemia (AMI) has a high mortality rate due to the development of bowel necrosis. Patients are often ruled outside active care if a large proportion of small bowel is necrotic. With the development of treatment for short bowel syndrome (SBS) and intestinal transplantation methods, long-term survival is possible even after extensive small bowel resections. This study aims to assess the incidence of SBS and potentially suitable candidates for intestinal transplantation among patients treated for AMI.
Methods:
This population-based retrospective study comprised patients aged less than 70 years and diagnosed with AMI between January 2006 and October 2020 in Helsinki and Uusimaa health care district, Finland.
Results:
Altogether, AMI was diagnosed in 711 patients, of whom 133 (19%) were aged below 70. An intervention was performed in 110 (83%) patients. Of these 133 patients, 16 (12%) were ruled outside active treatment due to extensive small bowel necrosis at exploratory laparotomy, of whom 6 (5%) were potentially suitable for intestinal transplantation. Two patients were considered as potential candidates for intestinal transplantation at bowel resection but died of AMI. Nine (7%) patients needed parenteral nutrition after resection, and two of them (2%) developed SBS. Only one patient needed long-term parenteral nutrition after hospital discharge. This patient remained dependent on parenteral nutrition but died before evaluation of intestinal transplantation could be carried out while the other patient was able to return to enteral nutrition.
Conclusions:
A small number of patients with AMI below 70 years of age are potentially eligible for intestinal transplantation.
Insights
A small number of patients under 70 with acute mesenteric ischemia (AMI) are potential candidates for intestinal transplantation. Early identification and treatment can improve outcomes for these critical cases.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Transplantation Medicine
Background:
- Acute mesenteric ischemia (AMI) carries a high mortality rate due to bowel necrosis.
- Advancements in short bowel syndrome (SBS) management and intestinal transplantation offer survival possibilities for extensive small bowel resections.
Purpose of the Study:
- To determine the incidence of SBS in AMI patients under 70.
- To identify potential candidates for intestinal transplantation among AMI patients.
Main Methods:
- Retrospective, population-based study of AMI patients under 70.
- Data collected from January 2006 to October 2020 in Finland.
- Analysis of intervention rates, need for parenteral nutrition, SBS development, and transplantation eligibility.
Main Results:
- 133 patients under 70 were diagnosed with AMI; 16% were excluded from active treatment due to extensive necrosis.
- 6% were identified as potential intestinal transplantation candidates.
- 2% developed SBS, with only one requiring long-term parenteral nutrition.
Conclusions:
- A limited number of younger AMI patients are eligible for intestinal transplantation.
- Early identification of candidates is crucial for improving survival in selected AMI cases.
