Intestinal transplantation for the treatment of neoplastic disease.
BACKGROUND
Authors reviewed single center experience of intestinal transplantation for treatment of intra-abdominal neoplastic disease.


METHODS
There were 25 auto- or allograft transplantations in 21 patients; desmoid tumor (14), neuroendocrine tumor (2), adenocarcinoma (2), hemangioma (1), lymphoma (1), and solid pseudopapillary tumor (1). Medical records were reviewed for cause of graft loss and mortality, recurrent neoplasm, and quality of life. Survival was analyzed using Kaplan-Meier method.


RESULTS
There were 11 graft losses; mortality with functioning graft (6), ischemic necrosis (2), acute or chronic rejection (2), and arterial thrombosis (1) during 38 months of mean follow-up. Seven patients died because of recurrent neoplasm and transplant related complications. Six patients experienced recurrent disease; three desmoid tumor (3/14), two adenocarcinoma (2/2), and one neuroendocrine tumor (1/2). Recurrent desmoid tumors were successfully treated with simple excision. Patient and graft survival in the desmoid tumor are 69.2% and 50.0% at 5 years after transplant. Among 14 survivors, 2 need parenteral nutrition or intravenous hydration. Twelve patients are working full time.


CONCLUSIONS
Intestinal transplantation is a reasonable life-saving treatment for catastrophic intra-abdominal neoplastic diseases.
Moon
Jang I
JI
Department of Surgery, Liver/GI Transplant, University of Miami Miller School of Medicine, Miami, Florida 33136, USA. jmoon@med.miami.edu
Selvaggi
Gennaro
G
Nishida
Seigo
S
Levi
David M
DM
Kato
Tomoaki
T
Ruiz
Philip
P
Bejarano
Pablo
P
Madariaga
Juan R
JR
Tzakis
Andreas G
AG
D000008:Abdominal Neoplasms / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D004386:Duodenum / Q000637:transplantation; D005260:Female; D018221:Fibromatosis, Abdominal / Q000473:pathology / Q000601:surgery*; D018222:Desmoid Tumors / Q000473:pathology / Q000601:surgery; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007422:Intestines / Q000637:transplantation*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation; D011788:Quality of Life; D012008:Recurrence; D013270:Stomach / Q000637:transplantation; D016019:Survival Analysis; D014184:Transplantation, Homologous