title: Abdominal multivisceral transplantation.
abstract: Under FK506-based immunosuppression, 13 abdominal multivisceral transplantations were performed in 6 children and 7 adults. Of the 13 recipients, 7 (53.8%) are alive and well with functioning grafts after 9 to 31 months. Six recipients died: three from PTLD, one from rejection, one from sepsis, and one from respiratory failure. In addition to rejection, postoperative complications occurring in more than isolated cases included PTLD (n = 6), abdominal abscess formation (n = 5), pancreatitis (n = 3), and ampullary dysfunction (n = 2). In addition, infection by enteric microorganisms was common during the early postoperative period. Currently, all 7 survivors are on an oral diet and have normal liver function. Two recipients (one insulin-dependent) require antidiabetes treatment, in one case following distal pancreatectomy and in the other after two episodes of pancreatic rejection. Thus, abdominal multivisceral transplantation is a difficult but feasible operation that demands complex and prolonged posttransplantation management. It is not yet ready for application and awaits a better strategy of immune modulation.
authors.affiliation: Pittsburgh Transplantation Institute, University of Pittsburgh Medical Center, Pennsylvania 15213.
authors.forename: S
authors.initials: S
authors.lastname: Todo
authors.forename: A
authors.initials: A
authors.lastname: Tzakis
authors.forename: K
authors.initials: K
authors.lastname: Abu-Elmagd
authors.forename: J
authors.initials: J
authors.lastname: Reyes
authors.forename: H
authors.initials: H
authors.lastname: Furukawa
authors.forename: B
authors.initials: B
authors.lastname: Nour
authors.forename: J
authors.initials: J
authors.lastname: Fung
authors.forename: A
authors.initials: A
authors.lastname: Demetris
authors.forename: T E
authors.initials: TE
authors.lastname: Starzl
mesh_terms: D000005:Abdomen; D000328:Adult; D002648:Child; D002675:Child, Preschool; D013505:Digestive System Surgical Procedures; D006084:Graft Rejection / Q000150:complications / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007422:Intestines / Q000637:transplantation*; D008232:Lymphoproliferative Disorders / Q000209:etiology; D008875:Middle Aged; D016019:Survival Analysis; D016559:Tacrolimus / Q000627:therapeutic use; D014781:Viscera / Q000637:transplantation*
chemical_list: D016559:Tacrolimus