Progressive functional adaptation of segmental bowel graft from living related donor.
We report a patient with short gut syndrome successfully treated with living related bowel transplantation. A 27-year-old Caucasian man was referred after traumatic loss of almost the entire bowel from the third portion of duodenum to the sigmoid colon. His HLA-identical sister volunteered as a donor. A 200-cm segment of ileum was successfully transplanted under tacrolimus-based immunosuppression. The posttransplant course was uneventful, without rejection or infectious complication. Total parenteral nutrition was discontinued 1 week posttransplant. At 6 months the patient had returned to his preinjury weight. Water and D-xylose absorption as well as fecal fat studies were markedly abnormal 1 month posttransplant but normalized by 6 months. The donor recovery was uneventful. A well-matched segmental ileal graft from living donor can provide complete rehabilitation for patients with short gut syndrome. We documented a progressive functional adaptation of the ileal graft, resulting in normal absorption by 5 months posttransplantation.
Department of Surgery, University of Illinois at Chicago, 60612, USA.
E
E
Benedetti
C
C
Baum
L
L
Cicalese
M
M
Brown
V
V
Raofi
M G
MG
Massad
H
H
Abcarian
D000328:Adult; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D019520:Living Donors; D008297:Male; D010288:Parenteral Nutrition; D011184:Postoperative Period; D012778:Short Bowel Syndrome / Q000534:rehabilitation / Q000601:surgery; D014184:Transplantation, Homologous / Q000502:physiology