Abstract

Intestinal Transplantation has immerged as the preferred treatment for patients with life threatening complications of intestinal failure. Results of Intestinal Transplantation have been slowly beginning to improve. Selection criteria and the matching of the right organ to the right patient has been a deliberate process. The organ shortage remains a legitimate obstacle particularly for very young children. results with transplantation are beginning to improve, demonstrating that it is a durable therapy for the treatment of intestinal failure. Various factors have been identified to impact long term outcomes while other factors have been shown not to be important. Clearly, a centers experience remains a central part of this. A center's strong commitment to the comprehensive care of patients with intestinal failure will lead to applying the correct therapy to the right form of therapy for each individual patient. The long term limitations of Intestinal Transplantation appear to be those that are similar to other forms of organ transplant and revolve primarily around chronic rejection. Continued development of means to monitor the allograft without doing biopsies remain in place. More effective immunosuppressive regimens will need to be developed that will take into account the interactions between the unique aspects of the small bowel and in particular how it relates to the external environment. The University of Nebraska Medical Center developed a liver-small bowel transplantation program in 1990, and isolated intestinal transplantation in 1993.

Keywords: Intestinal transplantation, immunosuppressive