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Multivisceral and Modified Multivisceral Intestinal Transplantation

  • Neslihan Celik
  • Geoff J. Bond
  • Kyle Soltys
  • Rakesh Sindhi
  • Jeffrey Rudolph
  • George MazariegosEmail author
Chapter
Part of the Springer Surgery Atlas Series book series (SPRISURGERY)

Abstract

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 [3]. The reasons for early failure were allograft rejection and infection [4].

Keywords

Abdominal transplantation Multivisceral transplantation Liver-sparing multivisceral transplantation Modified multivisceral transplantation Combined liver-intestine transplantation 

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Neslihan Celik
    • 1
  • Geoff J. Bond
    • 1
  • Kyle Soltys
    • 1
  • Rakesh Sindhi
    • 1
  • Jeffrey Rudolph
    • 2
  • George Mazariegos
    • 1
    Email author
  1. 1.Division of Pediatric Transplantation, Department of SurgeryHillman Center for Pediatric Transplantation, UPMC Children’s Hospital of PittsburghPittsburghUSA
  2. 2.Division of Gastroenterology, Department of PediatricsUPMC Children’s Hospital of PittsburghPittsburghUSA

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