title: Renal failure associated with intestinal transplantation: our experience in Spain.
abstract: BACKGROUND
  Renal failure (RF) is a frequent complication in non-renal solid organ transplants. In the present study, we analyze our experience with intestinal transplants (ITx).
  
  
  METHODS
  Between 2004 and 2012, we performed 21 ITx in 19 adult patients. Alemtuzumab was used as an induction agent followed by tacrolimus. Renal function was assessed before ITx and during the perioperative period.
  
  
  RESULTS
  The main cause for transplants was non-resectable desmoids tumors (33.3%), followed by vascular thrombosis (19%) and others. Medical complications were frequent, especially infectious diseases, which were the most common (51%). Surgical complications were also frequent, but most of them (>50%) were mild but leading to a great number of re-operations and prolonged stays in hospital. Acute rejection is very frequent (66.6%) but mild in more than 70% of the cases. Finally, RF was very frequent (68.4%; 13/19 patients) and accounted for 15.6% of all medical complications. Causes were multiple. One patient is awaiting a kidney transplant, but no other patients need renal replacement therapy at the moment. Ileostomy closure was performed in 5 of 12 patients alive, showing improved renal function in 3 of them.
  
  
  CONCLUSIONS
  RF is a problem in ITx and is always multifactorial. Increases in hospital stay, higher morbidity and is a cause for hospital readmission. Almost all patients had an impaired renal function when discharged. Immunosuppressants and ileostomy closure as soon as possible might prevent RF.
authors.affiliation: Department of Transplant Surgery, University Hospital 12 de Octubre, Madrid, Spain. Electronic address: jcalvopulido@outlook.es.
authors.forename: J
authors.initials: J
authors.lastname: Calvo Pulido
authors.affiliation: Department of Transplant Surgery, University Hospital 12 de Octubre, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Jiménez Romero
authors.affiliation: Department of Nephrology, University Hospital 12 de Octubre, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Morales Ruíz
authors.affiliation: Department of Transplant Surgery, University Hospital 12 de Octubre, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Cambra Molero
authors.affiliation: Department of Transplant Surgery, University Hospital 12 de Octubre, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Manrique Municio
authors.affiliation: Department of Transplant Surgery, University Hospital 12 de Octubre, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: García-Sesma
authors.affiliation: Department of Transplant Surgery, University Hospital 12 de Octubre, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Loinaz Segurola
authors.affiliation: Department of Transplant Surgery, University Hospital 12 de Octubre, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Abradelo de Usera
authors.affiliation: Department of Transplant Surgery, University Hospital 12 de Octubre, Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Justo Alonso
authors.affiliation: Department of Transplant Surgery, University Hospital 12 de Octubre, Madrid, Spain.
authors.forename: O
authors.initials: O
authors.lastname: Caso Maestro
authors.affiliation: Department of Transplant Surgery, University Hospital 12 de Octubre, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Alegre Torrado
authors.affiliation: Department of Transplant Surgery, University Hospital 12 de Octubre, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Moreno González
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D007410:Intestinal Diseases / Q000601:surgery*; D007421:Intestine, Small / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D055815:Young Adult