Abstract
Small bowel transplantation is the most physiological treatment for patients with short gut syndrome and intestinal failure. Severe rejection and infection still limit the frequency of small bowel transplantations performed. Isolated small bowel transplantation was performed in 10 adult patients with short gut syndrome. Seven patients (70%) are alive with good graft function. Acute rejection was observed in 3 patients (30%) and was steroid-resistant requiring OKT3 treatment in all. One patient died of acute steroid-resistant rejection after graft removal, 2 patients recovered from rejection after marked increase in baseline immunosuppression and repeated steroid pulses in combination with the TNF-α antibody infliximab. The incidence of infectious complications including bacterial and viral infections was low. This was achieved by a highly potent immunosuppressive management which was gradually tapered over time. The decrease in immunosuppression was guided by the use of soluble immune parameters and determination of cellular immune status. In summary, patient and graft survival compared well, rejection and infectious complications were low, and last not least, graft function and quality of life good in surviving recipients.
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© 2003 Springer-Verlag Berlin Heidelberg
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Müller, A.R. et al. (2003). Ergebnisse nach humaner Dünndarmtransplantation. In: Menger, M.D., Haas, N.P., Neugebauer, E., Bauer, H. (eds) Chirurgisches Forum 2003 für experimentelle und klinische Forschung. Deutsche Gesellschaft für Chirurgie, vol 32. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-19024-7_98
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DOI: https://doi.org/10.1007/978-3-642-19024-7_98
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-00659-6
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