INTESTINAL TRANSPLANTATION

Abstract

Intestinal transplantation is indicated when intestinal failure is considered permanent, and the administration of TPN is resulting in life-threatening complications. This has been operationally defined as: 1. Significant liver injury with abnormal hepatic enzymes. 2. Multiple central line infections. 3. Thrombosis of at least two central veins. 4. Frequent severe episodes of dehydration . The most common intestinal transplants can be categorized as follows: 1. Isolated intestine- transplantation of the small intestine with or without the large intestine. 2. En bloc liver intestine-the duodenum, pancreas, liver, and small intestine are included ‘in one piece’ so as not to disrupt the biliary tract. 3. Multivisceral- removal and replacement of the native foregut and midgut. Graft choice usually depends on the size of the recipient, the presence or absence of significant liver disease, and if there is significant pathology extending beyond the small intestine (e.g. pseudo-obstruction affecting stomach and small bowel). Summay