Intestinal transplantation: a clinical update

Until very recently the results of clinical small-bowel transplantation were disappointing. The latest developments indicate, however, that significant improvements have been made towards clinical application of this mode of therapy for patients with short-bowel syndrome.

Because of better immunosuppression and means to treat rejection, morbidity and mortality after small-bowel transplantation have been reduced and patient and graft survival has increased.

Septic complications and abnormal intestinal motility with functional problems remain pertinent problems. Nevertheless, a significant number of recipients have been able to stop TPN and resume a normal diet.

Although recent results of intestinal transplantation are encouraging, long-term survival is less than with other solid organ transplants. However, continued improvements in immunosuppression and the diagnosis of rejection as well as better management of functional and infectious problems will certainly improve future results.