Living Donor Intestinal Transplantation

Tzvetanov, Ivo; Tulla, Kiara; D’Amico, Giuseppe; Benedetti, Enrico

doi:10.1016/j.gtc.2018.01.008

Cited by 24 publications

(25 citation statements)

References 32 publications

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“…Intestinal transplantation is an effective treatment for various irreversible intestinal failures 1 . DBDs are one of the sources of organs for intestinal transplantation in most countries 3 . However, despite progressive improvement in immunosuppression, both the shortand long-term success rates for transplantation remain substantially inferior to solid organ, which may be related to the sensitivity of small intestine to ischemia.…”

Section: ■ Discussionmentioning

confidence: 99%

“…However, the number of patients on the waiting list for small bowel transplantation is larger than the number of available intestinal donors 1 . Currently, most small bowel transplantations are from deceased donors (DDs), while a few come from living donors (LDs) 2,3 . Nevertheless, cardiac death donors (DCDs) inevitably suffer a period of warm ischemia before organ donation, which attenuated the graft activity and clinical success of ITx.…”

Section: ■ Introductionmentioning

confidence: 99%

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Characterization of the intestinal graft in a swine hypotensive after brain death model

Li¹,

Gao

Chen

et al. 2019

Acta Cir. Bras.

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To establish a hypotensive brain death pig model and observe the effects of hypotension on small bowel donors. Methods: The hypotensive brain death model was produced using the modified intracranial water sac inflation method in ten domestic crossbred pigs. Effects of hypotensive brain death on small bowel tissue morphology were evaluated through changes in intestinal tissue pathology, tight junction protein of the intestinal mucosa and plasma intestinal fatty acid-binding protein (i-FABP) levels. The pathophysiological mechanism was examined based on changes in superior mesenteric artery (SMA) blood flow and systemic hemodynamics. Results: After model establishment, SMA blood flow, and the mean arterial pressure (MAP) significantly decreased, while heart rate increased rapidly and fluctuated significantly. Small bowel tissue morphology and levels of tight junction protein of the intestinal mucosa showed that after model establishment, small bowel tissue injury was gradually aggravated over time (P<0.05). Plasma i-FABP levels significantly increased after brain death (P<0.05). Conclusions: A hypotensive brain death pig model was successfully established using an improved intracranial water sac inflation method. This method offers a possibility of describing the injury mechanisms more clearly during and after brain death.

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Section: ■ Discussionmentioning

confidence: 99%

Section: ■ Introductionmentioning

confidence: 99%

Characterization of the intestinal graft in a swine hypotensive after brain death model

Li¹,

Gao

Chen

et al. 2019

Acta Cir. Bras.

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“…11 Specific patient groups may derive more of an advantage from LDIT, such as pediatric patients with short bowel syndrome who will likely require chronic total parental nutrition, because this may prevent the onset of end-stage liver disease (ESLD). 8 Compared with DD transplantation, LDIT offers improved tissue matching, decreased CIT, the opportunity to perform recipient desensitization, and the ability to schedule the surgery when the recipient is optimized. Data from small, retrospective pediatric research studies suggest that DD and LDIT patients may have similar graft and patient survival 12,13 ; however, the rates of LDIT are very low in the United States and worldwide, with only 44 LDITs performed in the United States since 1995.…”

Section: Living Donor Intestinal Transplantationmentioning

confidence: 99%

“…The large deficit of DD hepatic and renal grafts has led to the growth of living donor programs. In their review, Tzvetanov et al 8 argue that despite an ample supply of DD intestinal grafts, living donor intestinal transplantation (LDIT) may become an increasingly important source of organs for pediatric patients with both intestinal and liver failure, 8 a population with high waitlist mortality. 9 Based on the most recent OPTN/SRTR report, pediatric patients listed for liver/intestine transplant had a much higher waitlist mortality of almost 50 deaths per 100 waitlist years in 2005-2006, which decreased substantially to <10 deaths per 100 waitlist years in 2015-2016 10 ; however, this rate is still high compared to the waitlist mortality for pediatric kidney transplant patients of 1 to 2 deaths per 100 waitlist years.…”

Section: Intestinal Transplantationmentioning

confidence: 99%

Abdominal Organ Transplantation: Noteworthy Literature in 2018

Zerillo

Schlichting

Sakai

2019

Semin Cardiothorac Vasc Anesth

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A PubMed search revealed 1382 articles on pancreatic transplantation, 781 on intestinal transplantation, more than 7200 on kidney transplantation, and more than 5500 on liver transplantation published between January 1, 2018, and December 31, 2018. After narrowing the list down to human studies, 436 pancreatic, 302 intestinal, 1920 liver, and more than 2000 kidney transplantation studies were screened for inclusion in this review.

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“…Living‐related small bowel transplantation (LRSBTx) is a relatively standardized procedure that not only represents a valid alternative to cadaveric bowel transplant in selected cases but also demonstrates excellent results when performed in experienced centres. The availability of an identical twin as a donor, which allows immunosuppressive therapy to be avoided, is a major indication for this procedure .…”

mentioning

confidence: 99%