title: Mesenchymal stem cell therapy in patients with small bowel transplantation: single center experience.
abstract: OBJECTIVE
  To study the effects of mesenchymal stem cell (MSC) therapy on the prevention of acute rejection and graft vs host disease following small bowel transplantation.
  
  
  METHODS
  In our transplantation center, 6 isolated intestinal transplants have been performed with MSC therapy since 2009. The primary reasons for transplants were short gut syndrome caused by surgical intestine resection for superior mesenteric artery thrombosis (n = 4), Crohn's disease (n = 1) and intestinal aganglionosis (n = 1). Two of the patients were children. At the time of reperfusion, the first dose of MSCs cultured from the patient's bone marrow was passed into the transplanted intestinal artery at a dose of 1000000 cells/kg. The second and third doses of MSCs were given directly into the mesenteric artery through the arterial anastomosis using an angiography catheter on day 15 and 30 post-transplant.
  
  
  RESULTS
  The median follow-up for these patients was 10.6 mo (min: 2 mo-max: 30 mo). Three of the patients developed severe acute rejection. One of these patients did not respond to bolus steroid therapy. Although the other two patients did respond to anti-rejection treatment, they developed severe fungal and bacterial infections. All of these patients died in the 2(nd) and 3(rd) months post-transplant due to sepsis. The remaining patients who did not have acute rejection had good quality of life with no complications observed during the follow-up period. In addition, their intestinal grafts were functioning properly in the 13(th), 25(th) and 30(th) month post-transplant. The patients who survived did not encounter any problems related to MSC transplantation.
  
  
  CONCLUSIONS
  Although this is a small case series and not a randomized study, it is our opinion that small bowel transplantation is an effective treatment for intestinal failure, and MSC therapy may help to prevent acute rejection and graft vs host disease following intestinal transplantation.
authors.affiliation: Sait Murat Doğan, Selçuk Kılınç, Eyüp Kebapçı, Cem Tuğmen, Mustafa Ölmez, Cezmi Karaca, Organ Transplantation Center, SB Tepecik Teaching and Research Hospital, 35121 Izmir, Turkey.
authors.forename: Sait Murat
authors.initials: SM
authors.lastname: Doğan
authors.affiliation: Sait Murat Doğan, Selçuk Kılınç, Eyüp Kebapçı, Cem Tuğmen, Mustafa Ölmez, Cezmi Karaca, Organ Transplantation Center, SB Tepecik Teaching and Research Hospital, 35121 Izmir, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Kılınç
authors.affiliation: Sait Murat Doğan, Selçuk Kılınç, Eyüp Kebapçı, Cem Tuğmen, Mustafa Ölmez, Cezmi Karaca, Organ Transplantation Center, SB Tepecik Teaching and Research Hospital, 35121 Izmir, Turkey.
authors.forename: Eyüp
authors.initials: E
authors.lastname: Kebapçı
authors.affiliation: Sait Murat Doğan, Selçuk Kılınç, Eyüp Kebapçı, Cem Tuğmen, Mustafa Ölmez, Cezmi Karaca, Organ Transplantation Center, SB Tepecik Teaching and Research Hospital, 35121 Izmir, Turkey.
authors.forename: Cem
authors.initials: C
authors.lastname: Tuğmen
authors.affiliation: Sait Murat Doğan, Selçuk Kılınç, Eyüp Kebapçı, Cem Tuğmen, Mustafa Ölmez, Cezmi Karaca, Organ Transplantation Center, SB Tepecik Teaching and Research Hospital, 35121 Izmir, Turkey.
authors.forename: Alp
authors.initials: A
authors.lastname: Gürkan
authors.affiliation: Sait Murat Doğan, Selçuk Kılınç, Eyüp Kebapçı, Cem Tuğmen, Mustafa Ölmez, Cezmi Karaca, Organ Transplantation Center, SB Tepecik Teaching and Research Hospital, 35121 Izmir, Turkey.
authors.forename: Maşallah
authors.initials: M
authors.lastname: Baran
authors.affiliation: Sait Murat Doğan, Selçuk Kılınç, Eyüp Kebapçı, Cem Tuğmen, Mustafa Ölmez, Cezmi Karaca, Organ Transplantation Center, SB Tepecik Teaching and Research Hospital, 35121 Izmir, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Kurtulmuş
authors.affiliation: Sait Murat Doğan, Selçuk Kılınç, Eyüp Kebapçı, Cem Tuğmen, Mustafa Ölmez, Cezmi Karaca, Organ Transplantation Center, SB Tepecik Teaching and Research Hospital, 35121 Izmir, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Olmez
authors.affiliation: Sait Murat Doğan, Selçuk Kılınç, Eyüp Kebapçı, Cem Tuğmen, Mustafa Ölmez, Cezmi Karaca, Organ Transplantation Center, SB Tepecik Teaching and Research Hospital, 35121 Izmir, Turkey.
authors.forename: Cezmi
authors.initials: C
authors.lastname: Karaca
mesh_terms: D000208:Acute Disease; D000328:Adult; D002478:Cells, Cultured; D002648:Child; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007421:Intestine, Small / Q000637:transplantation*; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects; D012720:Severity of Illness Index; D012778:Short Bowel Syndrome / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D007166:Immunosuppressive Agents
keywords: Acute rejection; Mesenchymal stem cells; Short gut syndrome; Small bowel transplantation; Stem cell therapy