[Organ transplantations in intestinal tract surgery: history or future?]

In the case of three gastrointestinal organs - the esophagus, the stomach, and the colon - no indication for clinical transplantation is conceivable today or in future. On the other hand, experience with transplantation of the small bowel, the liver and the pancreas has already been gained, though up to now the results have been rather poor. Nevertheless, some clear indications exist which justify these transplantations in highly specialized centers. They include total loss, of the small bowel, multiple small bowel atresias, acute liver necrosis, congenital biliary atresia, Echinococcus alveolaris, in future some enzyme defects and finally, juvenile diabetes with nephropathy. Whether, and when, transplantation in these diseases becomes routine will depend on progress in immunology.