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Transplantation of the small intestine: the pathologist's perspective.

Banner, B and Hoffman, A and Cai, X and Starzl, TE and Sheahan, DG (1990) Transplantation of the small intestine: the pathologist's perspective. Am J Surg Pathol, 14 Sup. 109 - 116. ISSN 0147-5185

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Small-bowel transplantation is now ready for clinical trials. The surgical techniques and methods for immunosuppression and monitoring bowel status have been developed in animal models over the past 30 years. Several attempts at small-bowel transplantation in humans have already been reported. In the course of future trials, pathologists will be involved in the monitoring of the posttransplant course by mucosal biopsies and functional studies, including maltose and xylose absorption tests. The morphology of rejection has been studied in canine and rat models. Activated lymphocytes and plasma cells infiltrate the lamina propria and invade crypt epithelium, causing "cryptitis." Villous blunting ensues, resulting eventually in necrosis. Graft survival without immunosuppression is about 10 days. Under Cyclosporine immunosuppression, a lymphoplasmacytic infiltrate has been noted around nerves and vessels in the submucosa. The overlying mucosa may be relatively normal. End-stage bowel is characterized by a contracted, scarred mass. Due to the large amount of lymphoid tissue in the allograft, graft-versus-host disease is a significant problem in small-bowel transplantation.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Banner, B
Hoffman, A
Cai, X
Starzl, TEtes11@pitt.eduTES11
Sheahan, DG
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1990
Date Type: Publication
Journal or Publication Title: Am J Surg Pathol
Volume: 14 Sup
Page Range: 109 - 116
Institution: University of Pittsburgh
Refereed: Yes
Uncontrolled Keywords: Graft Rejection, Graft vs Host Disease, Humans, Intestine, Small, Intestines, Ischemia, Postoperative Complications, Postoperative Period, Surgical Procedures, Operative, Survival, Time Factors, Transplantation, Homologous
ISSN: 0147-5185
Other ID: uls-drl:31735062116979, Starzl CV No. 1144
Date Deposited: 08 Apr 2010 17:19
Last Modified: 17 Jan 2024 11:56


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