Living related small bowel transplantation: donor surgical technique.
OBJECTIVE
To describe a standardized technique for ileal graft procurement in the setting of living related bowel transplantation.


BACKGROUND
Living donor transplantation has been successfully developed for kidney, liver, pancreas, and lung transplantation. More recently, living related small bowel transplantation (LR-SBTx) has been developed with the aim of expanding the pool of intestinal graft donors and reducing the mortality in patients on the waiting list. To date, a total of 25 LR-SBTx worldwide have been reported to the international registry. We herein report the largest single center experience.


METHODS
A segment of ileum, 150 to 200 cm, is resected 20 cm proximal to the ileocecal valve (ICV), which is always preserved. The arterial inflow is given by the terminal branch of the superior mesenteric artery and venous outflow by a proximal segment of the superior mesenteric vein. The entire bowel is measured intraoperatively and at least 60% of intestine length is left in the donor.


RESULTS
Since 1998, we have performed 9 terminal ileum resections for small bowel donation. None of the donors has experienced persistent alteration of bowel habits or malabsorption; only 1 minor wound complication has occurred.


CONCLUSIONS
Terminal ileal resection with preservation of the ICV seems to assure fast functional recovery of the donor and has minimal postoperative complications.
Testa
Giuliano
G
Division of Pediatric Surgery, University of Illinois at Chicago, Chicago, Illinois 60612, USA.
Panaro
Fabrizio
F
Schena
Stefano
S
Holterman
Mark
M
Abcarian
Herand
H
Benedetti
Enrico
E
D000328:Adult; D005260:Female; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D020858:Tissue and Organ Harvesting / Q000379:methods*