Bowel transplantation still remains an experimental surgical procedure and has to be considered as a life-saving therapy. Improvements in immunosuppressive protocols renewed interest in intestinal transplantation as a theoretical choice of treatment for patients with irreversible intestinal failure. After prolonged total parenteral nutrition a chronic cholestatic liver failure may develop; in these patients combined liver-small-bowel transplantation is indicated. In patients with uncorrectable disorders of the entire gastrointestinal tract a multivisceral transplantation is indicated. The large quantity of lymphoreticular tissue included in the graft may induce a graft versus host disease although rejection remains the most imporiant immunological event. Clinical and experimental studies underline the importance of the bidirectional lymphoid cell traffic between the graft and the recipient creating a 'chimerism' in graft acceptance. For further improvements in survival and in quality of life of these patients new strategies for treatment of rejection and infections are required. The authors also report the results of their personal experience of liver-small bowel transplantation in the pig.
|Number of pages||9|
|Publication status||Published - 1995|
- intestinal rejection
- liver-small bowel allotransplantation
- multivisceral allotransplantation
- small bowel allotransplantation
ASJC Scopus subject areas