The recent achievements in the field of intestinal transplantation have produced a significant improvement of its results and the current survival rates of the graft and the recipient are almost comparable to other solid organ transplants. The indications of intestinal transplantation are limited to patients with intestinal failure who present with serious complications of total parenteral nutrition (TPN) or due to the underlying disease have a high risk of mortality despite uneventful TPN, to patients with locally invasive abdominal tumors and finally to intestinal transplant recipients whose graft has been explanted due to intractable acute rejection. The length of the graft and the difficulty to diagnose and treat the rejection episodes early in their course limits the use of intestinal transplantation to seriously ill patients with intestinal failure when all the other therapeutic options have failed. The excellent results of liver transplantation for the treatment of hepatic failure or liver metabolic disorders with serious systemic manifestations have increased the pool of potential recipients and consequently the need for hepatic grafts. Various surgical techniques have been developed to overcome the organ shortage: domino, reduced-liver, split-liver and more recently living related donor (LRD) liver transplantation. During the period 1994-2000 at the Miami University, Liver-Gastro-Intestinal Transplant Department 1270 liver transplants were performed including domino (n=6) and L-RD (n=26), as well as 99 intestinal transplants using isolate intestinal (n=29), combined liver-intestinal (n=30) and multivisceral (n=40) grafts. The advances in immunosuppression, the use of new methods to detect early and treat effectively acute rejection episodes, the flexibility of the surgical techniques and the efforts to modulate the immune system response to the graft constitute fields that contribute to the continuous evolution of liver-gastro-intestinal transplantation today.
|Original language||English (US)|
|Number of pages||8|
|Journal||Archives of Hellenic Medicine|
|Issue number||SUPPL. A|
|State||Published - Jan 1 2002|
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