Current Status of Intestinal Transplantation

Intestinal transplantation is an ultimate surgical option for patients with irreversible failure of the digestive system. There are multiple types of intestinal grafts: isolated intestine, liver-intestine, multivisceral, and modified multivisceral. Indications for intestine transplant include lack of vascular access for parenteral nutrition, development of liver dysfunction, multiple episodes of sepsis or dehydration. Diagnoses which lead to intestinal transplant include gastroschisis and volvulus in the pediatric population, mesenteric thrombosis and trauma in the adult population. Pediatric recipients account for a majority of all intestinal transplants. Monitoring of the intestinal graft requires endoscopy with biopsy, since noninvasive markers for rejection are not yet significantly reliable. Major complications after surgery include rejection and infection episodes. Long-term patient survival in intestinal recipients is achievable with good quality of life and normal enteral function, however, overall rates of patient and graft survival are not as high as in other organ transplants.