title: Italian experience in adult clinical intestinal and multivisceral transplantation: 6 years later.
abstract: METHODS
  Between December 2000 and November 2006, 28 isolated intestinal transplants and nine multivisceral transplants (five with liver) from cadaveric donors have been performed for short gut syndrome (n = 15), chronic intestinal pseudo-obstruction (n = 10), Gardner's syndrome (n = 9), radiation enteritis (n = 1), intestinal atresia (n = 1), and massive intestinal angiomatosis (n = 1). Indications for transplantations were: loss of venous access, recurrent sepsis due to central line infection, and/or major electrolyte and fluid imbalance. Liver dysfunction was present in 19 cases. All patients were adults of median age at transplant of 34.7 years and mean weight 59.6 kg. All recipients were on total parenteral nutrition for a mean time of 38.8 months. Mean donor/recipient body weight ratio was 1.1.
  
  
  RESULTS
  The mean follow-up was 892 +/- 699 days. Twenty-five patients were alive (67.5%) with 3-year patient survivals of 70% for isolated intestinal transplantations and 41% for the multivisceral transplantations (P = .01). The mortality rate was 32.5% with losses due to sepsis (63%) or rejection. Our 3-year graft survival rates were 70% for isolated intestinal transplantations and 41% for multivisceral transplantations (P = .02); graftectomy rate was 16%. These were 88% of grafts working properly with patients on regular diet with no need for parenteral nutrition.
  
  
  CONCLUSIONS
  Induction therapy has reduced the doses of postoperative immunosuppressive agents, especially in the first period, lowering the risk of renal failure and sepsis, mucosal surveillance protocol for early detection of rejection dramatically reduced the number of severe acute chronic rejections.
authors: Liver and Multiorgan Transplant Unit, University of Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy.
authors: A
authors: A
authors: Lauro
authors: C
authors: C
authors: Zanfi
authors: G
authors: G
authors: Ercolani
authors: A
authors: A
authors: Dazzi
authors: L
authors: L
authors: Golfieri
authors: A
authors: A
authors: Amaduzzi
authors: F
authors: F
authors: Pezzoli
authors: G L
authors: GL
authors: Grazi
authors: M
authors: M
authors: Vivarelli
authors: M
authors: M
authors: Cescon
authors: G
authors: G
authors: Varotti
authors: M
authors: M
authors: Del Gaudio
authors: M
authors: M
authors: Ravaioli
authors: A
authors: A
authors: Cucchetti
authors: G
authors: G
authors: La Barba
authors: M
authors: M
authors: Zanello
authors: G
authors: G
authors: Vetrone
authors: F
authors: F
authors: Tuci
authors: F
authors: F
authors: Catena
authors: G
authors: G
authors: Ramacciato
authors: L
authors: L
authors: Pironi
authors: A D
authors: AD
authors: Pinna
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007558:Italy; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods; D014781:Viscera / Q000637:transplantation*
chemical_list: D007166:Immunosuppressive Agents