Intestinal Transplantation: Surgical Techniques in Animals and Man

Abstract

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.