Outcomes after adult isolated small bowel transplantation: experience from a single European centre.
BACKGROUND
Adult isolated small bowel transplantation is considered the standard treatment for patients with life-threatening parenteral nutrition-related complications. Here, we report a 3-year experience in a single European centre between December 2000 and December 2003.


OBJECTIVE
To evaluate and discuss pre-transplant and post-transplant factors that influenced survival rates in our series.


METHODS
Fourteen patients, with a mean parenteral nutrition course of 27 months, were transplanted. In eight cases they had not experienced any major complication from parenteral nutrition.


METHODS
We described pre-transplant evaluation and inclusion criteria, surgical technique and clinical management after transplant. Immunosuppressive therapy was based on induction drugs and Tacrolimus. We reported survival rates, major complications and rejection events.


RESULTS
One-year actuarial survival rate was of 92.3% with a mean 21-month follow-up (range 3-36 months). We had no intraoperative deaths. One patient (7.2%) died of sepsis following cytomegalovirus enteritis. One patient underwent graftectomy (7.2%) for intractable severe acute rejection. One-year actuarial graft survival rate of 85.1%. One patient (7.2%) affected by post-transplant lymphoproliferative disease is alive and disease-free after 8 months.


CONCLUSIONS
We believe candidate selection, induction therapy, donor selection and short ischemia time play an important role in survival after small bowel transplantation.
Di Benedetto
F
F
Liver and Multivisceral Transplant Centre, University of Modena and Reggio Emilia, Policlinico of Modena-via del Pozzo 71, 41100 Modena, Italy. f.diben@virgilio.it
Lauro
A
A
Masetti
M
M
Cautero
N
N
Quintini
C
C
Dazzi
A
A
De Ruvo
N
N
Uso
T Diago
TD
Begliomini
B
B
Siniscalchi
A
A
Bagni
A
A
Codeluppi
M
M
Ramacciato
G
G
Villa
E
E
Pinna
A D
AD
D000328:Adult; D013505:Digestive System Surgical Procedures / Q000379:methods; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007413:Intestinal Mucosa / Q000187:drug effects / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D016019:Survival Analysis; D015996:Survival Rate; D016378:Tissue Transplantation / Q000009:adverse effects / Q000401:mortality*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents