[Clinical results of intestinal and multivisceral transplantation at the Charité, Berlin. A case series].
OBJECTIVE
Intestinal transplantation (ITx) is the only causal therapy of short bowel syndrome (SBS). Long-term survival after ITx has been improved significantly during the last years. The experience with ITx at the Charite, Campus Virchow Klinikum, are described and discussed.


METHODS
Twelve isolated ITx and one multivisceral transplantation (including stomach, pancreatodudenal complex, small intestine, liver, ascending colon, right kidney, and adrenal gland) were performed. Mean recipient age was 37.7+/-10.6 yrs (median: 35 yrs; range: 27 - 58 yrs; M:F = 8:5). All patients had irreversible SBS (0 - 30 cm residual bowel length; mean: 11.8+/-11.4 cm; median: 13 cm).


RESULTS
6-months and 1-year patient and graft survival were 85 % (11/13) and 77 % (10/13), respectively. Reasons for graft loss and patient death were necrotizing enterocolitis, severe, muromonab-resistent, acute rejection, and graft ischemia due to complex coagulopathy. All other patients had good long-term outcome. They received enteral nutrition at six hours after operation and were persistently off total parenteral nutrition (TPN) by week two after ITx.


CONCLUSIONS
ITx as established in our centre, with 1-year-patient and graft survival rates of 77 %, reflects current international standard. ITx is complementary to conservative and other operative methods of treating SBS. Referral and indication criteria need wider dissemination to prevent life-threatening complications of TPN.
Pascher
A
A
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie. andreas.pascher@charite.de
Klupp
J
J
Schulz
R J
RJ
Kohler
S
S
Junge
G
G
Sauer
I M
IM
Veltzke-Schlieker
W
W
Adler
A
A
Guckelberger
O
O
Nüssler
N C
NC
Dignass
A
A
Langrehr
J M
JM
Neuhaus
P
P
D000293:Adolescent; D000311:Adrenal Glands / Q000637:transplantation; D000328:Adult; D001604:Berlin; D002648:Child; D004750:Enteral Nutrition; D020345:Enterocolitis, Necrotizing / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007421:Intestine, Small / Q000637:transplantation; D007422:Intestines / Q000637:transplantation*; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012778:Short Bowel Syndrome / Q000601:surgery* / Q000628:therapy; D013270:Stomach / Q000637:transplantation; D015996:Survival Rate; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data
D007166:Immunosuppressive Agents