First Spanish series of intestinal transplantation in adult recipients

Abstract

Background: short-bowel transplantation has experienced a substantial growth worldwide following improved results from the late 1990s on, and its coverage by Medicare. According to the International Registry , a total of 1,292 intestinal trasplants for 1,210 patients in 65 hospitals across 20 countries have been carried out thus far.Objective: to know short-term (6 months) results regarding patient and graft survival from the first Spanish series of intestinal transplants in adult recipients.Material and methods: we present our experience in the assessment of 20 potential candidates to short-bowel transplantation between June 2004 and October 2005. Of these, 10 patients were rejected and 4 were transplanted, which makes up the sample of our study.Results: to this date 5 transplants have been carried out in 4 patients (2 retransplants, 2 desmoid tumors, 1 short bowel syndrome after excision as a result of mesenteric ischemia). Upon study completion and after a mean follow-up of 180 days (range 90-190 days) all recipients are alive, and all grafts but one (75%) are fully operational, with complete digestive autonomy. All patients received induction with alemtuzumab except one, who received thymoglobulin; in all induction was initiated with no steroids.Conclusions: intestinal transplantation represents a therapeutic option that is applicable in our setting and valid for recipients with an indication who have no other feasible alternative to keep their intestinal failure under control.

Infectious Complications Following Small Bowel Transplantation

“…Likewise, we detected the specific problem of meshrelated infections after adult SBT. Abdominal wall closure after SBT is technically challenging due to the lack of intraperitoneal space and the risk of intra-abdominal compartmental syndrome (17). Consequently, primary wall closure is avoided in many cases, and the use of meshes with sequential reduction until closure completion is a common alternative in these patients (17).…”

“…Abdominal wall closure after SBT is technically challenging due to the lack of intraperitoneal space and the risk of intra-abdominal compartmental syndrome (17). Consequently, primary wall closure is avoided in many cases, and the use of meshes with sequential reduction until closure completion is a common alternative in these patients (17). Although mesh-related infection is not usually life-threatening, its occurrence leads to posttransplant reintervention, use of indwelling catheters for longer periods of time and prolongation of hospital stay.…”

Potential for intestinal transplantation after acute mesenteric ischemia in patients aged less than 70 years: A population-based study

“…[36][37][38] Globally, AMI is also a common etiology among patients requiring intestinal transplantation. 22,36,39 To the best of our knowledge, there are no recent long-term follow-up studies on AMI, and it is unclear how many AMI patients would develop intestinal failure and qualify for intestinal transplantation.…”