Small bowel transplantation |
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| Authors: | Sami Asfar MD FRCS Paul Atkison MD FRCPC Cameron Ghent MD FRCPC John Duff MD FRCSC William Wall MD FRCSC Sandy Williams RN Ernest Seidman MD FRCPC Dr. David Grant MD FRCSC |
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| Affiliation: | (1) From the Multi-Organ Transplant Service, University Hospital and the Children's Hospital of Western Ontario, London, Ontario, Canada;(2) Ste-Justine Hospital, University of Montreal, Quebec, Canada |
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| Abstract: | Thirty-seven patients were listed for small bowel transplantation; 16 were transplanted and 15 died while waiting for a donor. Cyclosporine (N=6) or tacrolimus (N=10) were used for immune suppression. Graft rejection rates were lower in the combined liver/small bowel grafts than the isolated intestinal transplants (1/7 vs 5/7;P<0.01) All of the cyclosporine group have died; the median survival was 25.7 months with two patients living more than five years. The tacrolimus group had fewer infections and a shorter hospital stay. All but two are alive with a median survival of 13 months. Seven of eight long-term survivors are off intravenous feedings. We conclude that small bowel transplantation is a life-saving option for patients with intestinal failure who cannot be maintained on total parenteral nutrition. |
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| Keywords: | intestinal transplantation tacrolimus cyclosporine short bowel syndrome |
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