Summary:
Intestinal transplantation is the logical alternative to definitive total parenteral nutrition in patients with chronic intestinal
failure. It has become a lifesaving procedure for patients with intestinal failure who cannot be treated using conventional
therapies. In children (over 50% of the recipients) indications include short gut syndrome, primary disorders of intestinal
motility and mucosal diseases. In adults, the major indication for intestinal transplantation is inadaptable short bowel
syndrome after total or subtotal resection. Patients with irreversible intestinal failure and total parenteral nutrition dependency
without consistent liver disease must be considered as candidates for isolated small bowel transplantation. Patients with
irreversible intestinal failure and end-stage liver diseases are candidates for lifesaving procedure such as combined liver-small
bowel transplantation. The appropriate timing for transplantation remains vague. Advanced disease has further consequences
because a considerable number of patients may die of progressive liver failure or infection before suitable organs are available.
Candidates for intestinal transplantation should be assessed early and should undergo transplantation.
Key words:
small bowel transplantation, indications, results, our experiences.