title: Belgian multicenter experience with intestinal transplantation.
abstract: Intestinal transplantation (ITx) has evolved from an experimental procedure toward a clinical reality but remains a challenging procedure. The aim of this survey was to analyze the multicenter Belgian ITx experience. From 1999 to 2014, 24 ITx in 23 patients were performed in Belgium, divided over five centers. Median recipient age was 38 years (8 months-57 years); male/female ratio was 13/10; six were children; and 17 adults. Intestinal failure was related to intestinal ischemia (n = 5), volvulus (n = 5), splanchnic thrombosis (n = 4), Crohn (n = 2), pseudo-obstruction (n = 2), microvillus inclusion (n = 2), Churg-Strauss (n = 1), necrotizing enterocolitis (n = 1), intestinal atresia (n = 1), and chronic rejection (n = 1). Graft type was isolated ITx (n = 9), combined liver-ITx (n = 11) and multivisceralTx (n = 4). One was a living donor-related transplantation and five patients received simultaneously a kidney graft. Early acute rejection occurred in 8; late acute rejection in 4; and chronic rejection in 2. Two patients developed a post-transplant lymphoproliferative disease. Nine patients have died. Among 14 survivors at last follow-up, 11 have been transplanted for more than 1 year. None of the latter has developed renal failure, and all were nutritionally independent with a Karnofsky score > 90%. One-/five-year patient and graft survivals were 71.1%, 62.8%, 58.7% and 53.1%, respectively. Based on this experience, ITx has come of age in Belgium as a lifesaving and potentially quality of life restoring therapy.
authors.affiliation: Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium.|Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors.forename: Laurens J
authors.initials: LJ
authors.lastname: Ceulemans
authors.affiliation: Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium.|Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors.forename: Diethard
authors.initials: D
authors.lastname: Monbaliu
authors.affiliation: Department of Abdominal Surgery and Transplantation, University Hospital of Liège, Liège, Belgium.
authors.forename: Arnaud
authors.initials: A
authors.lastname: De Roover
authors.affiliation: Department of Abdominal Surgery and Transplantation, University Hospital of Liège, Liège, Belgium.
authors.forename: Olivier
authors.initials: O
authors.lastname: Detry
authors.affiliation: Department of General and Hepatobiliary Surgery, Liver Transplantation Service, Ghent University Hospital, Ghent, Belgium.
authors.forename: Roberto I
authors.initials: RI
authors.lastname: Troisi
authors.affiliation: Department of General and Hepatobiliary Surgery, Liver Transplantation Service, Ghent University Hospital, Ghent, Belgium.
authors.forename: Xavier
authors.initials: X
authors.lastname: Rogiers
authors.affiliation: Department of Abdominal Surgery and Transplantation, University Hospitals Saint Luc - UCL, Brussels, Belgium.
authors.forename: Raymond
authors.initials: R
authors.lastname: Reding
authors.affiliation: Department of Abdominal Surgery and Transplantation, University Hospitals Saint Luc - UCL, Brussels, Belgium.
authors.forename: Jan P
authors.initials: JP
authors.lastname: Lerut
authors.affiliation: Department of Hepatobiliary and Transplantation Surgery, Antwerp University Hospital, Antwerp, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Ysebaert
authors.affiliation: Department of Hepatobiliary and Transplantation Surgery, Antwerp University Hospital, Antwerp, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Chapelle
authors.affiliation: Abdominal Transplant Surgery, University Hospitals Leuven, Leuven, Belgium.|Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: Pirenne
mesh_terms: D000293:Adolescent; D000328:Adult; D001530:Belgium; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007165:Immunosuppression Therapy; D007223:Infant; D007410:Intestinal Diseases / Q000601:surgery / Q000628:therapy; D007422:Intestines / Q000637:transplantation*; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008232:Lymphoproliferative Disorders / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Belgium; Eurotransplant; intestinal failure; intestinal transplantation; multivisceral transplantation