title: Initial Experience of Video Capsule Endoscopy After Intestinal Transplantation.
abstract: BACKGROUND
  Intestinal transplantation is a procedure which inflicts immunological and infectious complications that affect the transplanted graft, posing both diagnostic and therapeutic challenges. Video capsule endoscopy (VCE) offers easy access to the entire small intestine and presents itself as an interesting option. However, at present, no studies evaluating the usefulness of video capsule endoscopies in this setting have been published. Our aim was to evaluate the usefulness of VCE in detecting complications that arise after intestinal transplantation.
  
  
  METHODS
  We included 7 adult patients with either isolated intestine (n = 1) or multivisceral grafts (n = 6). These patients underwent 12 VCE between 2004 and 2015 at the Sahlgrenska University Hospital. The median age was 42 (21-67) years (4 women/3 men). VCE was used in clinical situations where the conventional diagnostic methods failed to provide answers to the clinical question.
  
  
  RESULTS
  Indications for the procedure were: suspicion of rejection (n = 4 examinations), gastrointestinal dysmotility (n = 4 examinations), high stomal output (n = 2 examinations), suspicion of lymphoproliferative disease in the transplanted graft (n = 1 examination), and clinical surveillance (n = 1 examination). The median time after transplantation for performing an examination was 740 (26-3059) days. VCE was useful in 83% of the examinations and the results influenced the planned management. The overall agreement between VCE findings and biopsies was moderate (κ = 0.54,P= 0.05) but increased when comparing the presence of inflammation/rejection (κ = 0.79,P< 0.001).
  
  
  CONCLUSIONS
  VCE is a promising diagnostic method after intestinal transplantation. However, larger studies are needed to evaluate its potential risks and gains.
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Varkey
authors.affiliation: Transplant Institute, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Mihai
authors.initials: M
authors.lastname: Oltean
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Andreas Bernd
authors.initials: AB
authors.lastname: Pischel
authors.forename: Magnus
authors.initials: M
authors.lastname: Simrén
authors.affiliation: Transplant Institute, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Gustaf
authors.initials: G
authors.lastname: Herlenius