Segmental living related small bowel transplantation in adults

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
L CicaleseEnrico Benedetti

Abstract

The advent of small bowel transplantation has provided selected patients with chronic intestinal irreversible failure with a physiologic alternative to total parenteral nutrition. Recently a standardized technique for living related small bowel transplantation (LR-SBTx) has been developed. Three patients with short bowel syndrome underwent LR-SBTx at our institution. All donors were ABO compatible with a good human leukocyte antigen match. A segment of 180 to 200 cm of ileum was harvested and transplanted with its vascular pedicle constituted by the ileocolic artery and vein. The grafts were transplanted with a short cold and warm ischemia time. The immunosuppression regimen consisted of oral FK-506, prednisone, and intravenous induction with atgam. Serial biopsies of the intestinal grafts were performed to evaluate rejection or viral infections. The postoperative course was uneventful for all donors. All of the recipients are currently alive and well. Two of three patients are off total parenteral nutrition and tolerating an oral diet with no limitations on daily activity. In the third patient, the graft was removed 6 weeks after transplantation. At the time of enterectomy, no technical or immunologic complications were docume...Continue Reading

Associated Clinical Trials

Citations

Feb 1, 2003·Annals of Surgery·Toshiyuki TanakaMichael G Sarr
Jul 11, 2006·World Journal of Gastroenterology : WJG·Da-Xun PiaoYing-Hui Guan
Jan 26, 2007·Langenbeck's Archives of Surgery·Felix BraunFred Faendrich
Aug 10, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Giovanni FrongiaArianeb Mehrabi
Mar 13, 2003·World Journal of Gastroenterology : WJG·Jie DingBo-Rong Pan
Oct 24, 2002·The Journal of Trauma·Evangelos TzoracoleftherakisEnrico Benedetti

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