Intestinal Transplantation: Surgical Techniques in Animals and Man
The physiologic and surgical basis for a successful experimental small-intestinal transplantation was first investigated by Richard Lillehei and coworkers (1959). Work at that time focused on the effects of intestinal ischemia on body hemodynamics, as well as on problems related to intestinal in vitro preservation and subsequent reimplantation. It was demonstrated that the small bowel could be removed from a dog, stored outside the body for 2 h, and then reimplanted. It was also demonstrated that the autotransplanted small intestine could sustain life in the experimental animal and that after an initial period of diarrhea these dogs gained weight. During the following decade, a large number of experimental reports were presented. Despite the fact that long-term survival in allotransplanted experimental animals was not consistantly achieved, a small number of cases of intestinal transplantation in man were attempted. However, these clinical attempts were universally unsuccessful, with the longest survival being only 79 days, and experimental research activity diminished.
KeywordsIschemia Lactate Diarrhea Cyclosporine Prednisone
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- Debonguie JC, Phillips SC (1978) Capacity of the human colon to absorb fluid. Gastroenterology 74: 698–703Google Scholar
- Deltz E (1981) Die allogene Dünndarmtransplantation. Zuckschwerdt, Munich (Thesis )Google Scholar
- Diliz-Perez HS, McClure J, Bedetti C, Hong HQ, de Santibanes E, Shaw BW, van Thiel D, Iwatsuki S, Starzl T (1984) Successful small bowel allotransplantation in dogs with cyclosporine and prednisone. Transplantation 37: 126–129Google Scholar
- Garrido H, de Diego JA, Cano MC, Lucea C, Escribano PM, Manzanos A (1975) Homograft of the small intestine. Metabolic and functional changes causing irreversible shock. Int Surg 60: 251–254Google Scholar
- Olivier G, Rettori F, Olivier C (1969) Homotransplantation orthotopique de l’intestin grêle et des côlons droit et transverse chez l’homme. J Chir 98: 323Google Scholar
- Ruiz JO, Lillehei RC (1972) Intestinal transplantation. Surg Clin North Am 52: 1075–1091Google Scholar
- State D (1969) Experimental studies in intestinal allografts. Surg Clin North Am 49: 547–552Google Scholar
- Toledo-Pereyra LH, Simmons RL, Najarian JS (1974 a) Prolonged survival of canine orthotopic small intestinal allografts preserved for 24 hours by hypothermic bloodless perfusion. Surgery 75: 368–376Google Scholar
- Toledo-Pereyra LH, Raij L, Simmons RL, Najarian JS (1974b) Role of endotoxin and bacteria in long-term survival of preserved small-bowel allografts. Surgery 73: 474–481Google Scholar