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Kidney Transplant I: Introduction01:28

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...

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Living Donor Intestinal Transplantation: Evolution and Results.

Rainer W G Gruessner1

  • 1SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA.

Gastroenterology Clinics of North America
|May 27, 2026
PubMed
Summary

Living donor intestinal transplantation offers comparable outcomes to deceased donor transplants, with benefits like shorter ischemia times and reduced waiting list mortality for short bowel syndrome patients.

Keywords:
Intestinal transplantationLiving donorLiving donor intestinal and liver transplantationLiving donor intestinal transplantationPre-emptive living donor intestinal transplantationStandardized surgical technique

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Area of Science:

  • Gastroenterology and Hepatology
  • Transplant Surgery

Background:

  • Short bowel syndrome (SBS) is a severe condition often requiring intestinal transplantation.
  • Living donor (LD) intestinal transplantation presents potential advantages over deceased donor (DD) transplantation.

Purpose of the Study:

  • To compare the outcomes of living donor (LD) versus deceased donor (DD) intestinal transplantation.
  • To highlight the safety and reproducibility of standardized LD intestinal transplantation techniques.

Main Methods:

  • Standardized procurement of approximately 200 cm of donor distal ileum (100 cm in children) on a vascular pedicle.
  • Connection of graft vessels to recipient systemic circulation.
  • Creation of an ileostomy for graft biopsy access.

Main Results:

  • LD transplantation offers shorter ischemia times and improved human leukocyte antigen matching.
  • Reduced waiting-list mortality and potential for preemptive transplantation before liver disease development.
  • Excellent graft function and independence from total parenteral nutrition (TPN) are frequently observed.
  • Outcomes for LD versus DD intestinal transplantation are at least comparable.

Conclusions:

  • Living donor intestinal transplantation is a safe and reproducible option for treating short bowel syndrome.
  • LD transplantation provides significant benefits, including reduced waiting times and comparable or superior outcomes to DD transplantation.