Multivisceral and Modified Multivisceral Intestinal Transplantation
More than half a century ago, multivisceral intestinal transplantation (MVT) was undertaken experimentally on canines by Starzl et al. [1, 2] despite concerns over predicting immunologic outcomes and uncertain lymphatic drainage. The graft was designed as a grape cluster with a double central stem consisting of celiac axis and superior mesenteric artery (SMA), which would allow future modifications. The venous outflow of this grape cluster was hepatopedal; it was kept intact up to or beyond the liver [1, 2]. The first human MVT was also performed by Starzl et al. in 1983 and 1989 in two pediatric cases, but clinically reproducible results awaited the introduction of tacrolimus in 1989 . The reasons for early failure were allograft rejection and infection .
KeywordsAbdominal transplantation Multivisceral transplantation Liver-sparing multivisceral transplantation Modified multivisceral transplantation Combined liver-intestine transplantation
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