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Intestinal transplantation in composite visceral grafts or alone

Todo, S and Tzakis, AG and Abu-Elmagd, K and Reyes, J and Nakamura, K and Casavilla, A and Selby, R and Nour, BM and Wright, H and Fung, JJ and Demetris, AJ and Van Thiel, DH and Starzl, TE and Busuttil, RW and Rapaport, FT and Vasconez, LO and Thompson, JC and Shaw, BW (1992) Intestinal transplantation in composite visceral grafts or alone. Annals of Surgery, 216 (3). 223 - 234. ISSN 0003-4932

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Abstract

Under FK 506-based immunosuppression, the entire cadaver small bowel except for a few proximal and distal centimeters was translated to 17 randomly matched patients, of whom two had antigraft cytotoxic antibodies (positive cross-match). Eight patients received the intestine only, eight had intestine in continuity with the liver, and one received a full multivisceral graft that included the liver, stomach, and pancreas. One liver-intestine recipient died after an intestinal anastomotic leak, sepsis, and graft- versus-host disease. The other 16 patients are alive after 1 to 23 months, in one case after chronic rejection, graft removal, and retransplantation. Twelve of the patients have been liberated from total parenteral nutrition, including all whose transplantation was 2 months or longer ago. The grafts have supported good nutrition, and in children, have allowed growth and weight gain. Management of these patients has been difficult and often complicated, but the end result has been satisfactory in most cases, justifying further clinical trials. The convalescence of the eight patients receiving intestine only has been faster and more trouble free than after liver-intestine or multivisceral transplantation, with no greater difficulty in the control of rejection.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Todo, S
Tzakis, AG
Abu-Elmagd, K
Reyes, J
Nakamura, K
Casavilla, A
Selby, R
Nour, BM
Wright, H
Fung, JJ
Demetris, AJ
Van Thiel, DH
Starzl, TEtes11@pitt.eduTES11
Busuttil, RW
Rapaport, FT
Vasconez, LO
Thompson, JC
Shaw, BW
Centers: Other Centers, Institutes, or Units > Thomas E. Starzl Transplantation Institute
Date: 9 October 1992
Date Type: Publication
Journal or Publication Title: Annals of Surgery
Volume: 216
Number: 3
Page Range: 223 - 234
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0003-4932
Other ID: uls-drl:31735062111913, Starzl CV No. 1399
Date Deposited: 08 Apr 2010 17:23
Last Modified: 13 Oct 2017 21:57
URI: http://d-scholarship.pitt.edu/id/eprint/4785

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