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Small bowel transplantation: current progress and clinical application

E E Frezza1, A Tzakis, J J Fung

  • 1Pittsburgh Transplantation Institute, PA, USA.

Hepato-Gastroenterology
|March 1, 1996
PubMed
Summary
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Total parenteral nutrition (TPN) is a common treatment for Short Bowel Syndrome (SBS) but has risks. Small bowel transplantation (SBT) offers an alternative, with advancements improving graft survival and patient outcomes.

Area of Science:

  • Gastroenterology
  • Transplantation Surgery
  • Immunology

Background:

  • Total parenteral nutrition (TPN) is the standard treatment for Short Bowel Syndrome (SBS), but it is costly and limits lifestyle.
  • Complications and risks associated with long-term TPN necessitate alternative treatments.
  • Early attempts at small bowel transplantation (SBT) faced challenges with graft rejection and Graft Versus Host Disease (GVHD).

Purpose of the Study:

  • To review the historical development of small bowel transplantation (SBT).
  • To summarize the progress and current status of SBT up to 1992.
  • To highlight advancements in immunosuppression and surgical techniques for intestinal transplantation.

Main Methods:

  • Review of clinical literature and historical data on small bowel transplantation.

Related Experiment Videos

  • Analysis of early transplantation attempts and their outcomes.
  • Examination of advancements in immunosuppressive agents like FK 506 and their impact on graft survival.

    • Main Results:

    • Early SBT attempts were hampered by graft rejection and GVHD.
    • Significant progress in SBT was reported in 1988 with multivisceral grafts.
    • Introduction of FK 506 improved outcomes compared to Cyclosporine A (CsA).
    • Longest survival reported was over two years in a pediatric patient.

    Conclusions:

    • Small bowel transplantation has evolved significantly, demonstrating clinical utility.
    • Advancements in immunosuppression and surgical approaches have improved graft survival rates.
    • SBT represents a viable alternative for select patients with SBS, offering improved quality of life.