Small intestine transplantation today

Braun, Felix; Broering, Dieter; Faendrich, Fred

doi:10.1007/s00423-006-0134-5

Cited by 15 publications

(13 citation statements)

References 103 publications

(122 reference statements)

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“…1 Despite recent advances in immunosuppressive strategies, surgical and perioperative techniques, and increased understanding of acute rejection of vascularized organs, the long-term survival of vascularized allografts has not improved, largely due to chronic rejection (CR). CR remains a major concern -an indolent but progressive form of graft injury that eventually results in graft failure.…”

Section: List Of Abbreviationsmentioning

confidence: 99%

FK506 treatment in a Long-term chronic rejection rat model of small bowel transplantation

Zhu¹,

Wei²,

Li³

2010

CIM

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Background: Although acute rejection (AR) can be significantly improved by effective immunosuppressants, such as FK506, chronic rejection (CR) remains a major hurdle to long-term allograft survival after small bowel transplantation, in part because the pathogenic mechanisms of CR are, as yet, unknown. The rat orthotopic small bowel transplantation (OSBT) model has been used by a few researchers, but without long-term survival. Methods: Rats were randomly divided into five groups: Group 1 (n=20), sham-operation rats; Group 2 (n=20), Lewis to Lewis; Group 3 (n=20), F344 to Lewis treated with FK506 (0.3 mg/kg/day); Group 4 (n=20), F344 to Lewis with FK506 (0.5 mg/kg/day); Group 5 (n=20), F344 to Lewis with FK506 (1.0 mg/kg/day). FK506 was administrated intramuscularly to recipients on postoperative days (POD) 0-13, 20 and 27. Body weight, survival rate and histology were measured. Results: Histopathological analysis revealed distinctive abnormalities of the allograft for all animals, including changes in villous architecture, interstitial fibrosis and intimal thickening; however, survival times were significantly increased with higher doses of FK506. Rats in Group 3 and Group 4 (low and moderate FK506 doses) survived 16-18 weeks, while recipients in Group 5 (high dose) survived 24-27 weeks.

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Section: List Of Abbreviationsmentioning

confidence: 99%

FK506 treatment in a Long-term chronic rejection rat model of small bowel transplantation

Zhu¹,

Wei²,

Li³

2010

CIM

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“…В по следние годы благодаря современной иммуносупрессии, совершенствованию хирургической техники и послеопе рационного ведения реципиента в мире отмечено увели чение числа ТТК и улучшение результатов лечения [1,2].…”

Section: Introductionunclassified

Enteral Feeding as a Part of Combination Treatment in a Patient after Small Intestine Transplantation

Хубутия¹,

Рык²,

Киселев³

et al. 2014

rmt

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“…Rygick e Nasarov 19 , em 1969, propuseram um método de inversão de segmento ileal de aproximadamente 20 cm criando um segmento anti-peristáltico de delgado, lentificando a passagem do quimo e aumentando absorção, porém, obtendo como consequência uma dilatação à montante da anastomose proximal. Transplante de intestino delgado é hoje realizado com resultados promissores, mas há insuficiente descrição literária principalmente pela restrição de candidatos ao procedimento 5,7,18 . A técnica de alongamento intestinal com redução do diâmetro luminal foi primeiramente descrita por Bianchi em 1980 8 com subsequentes relatos de sucesso no manejo cirúrgico da SIC em crianças e neonatos 2,10,17,27,32 .…”

Section: Introductionunclassified

Síndrome do intestino curto: uma nova alternativa de tratamento cirúrgico

Franzon¹,

Suzuki²,

Sato³

et al. 2010

ABCD, arq. bras. cir. dig.

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DESCRITORES -Síndrome do intestino curto. Nutrição parenteral total. Cirurgia.RESUMO -Introdução -A síndrome do intestino curto resulta de comprimento total de intestino delgado inadequado para manter a nutrição, e assim, os pacientes tornam-se cronicamente dependentes de nutrição parenteral total. Numerosas estratégias cirúrgicas foram estudadas para restabelecer a função intestinal normal. Objetivo -Propor a utilização da inversão de segmento de alça associada à STEP -Serial Transverse Enteroplasty -para aumentar a área absortiva intestinal em pacientes com síndrome do intestino curto. Método -Os autores descrevem uma nova alternativa para o tratamento cirúrgico da síndrome do intestino curto, demonstrando sua facilidade e eficiência para o objetivo proposto. Resultados -As duas técnicas associadas permitiram alongar a alça intestinal em 2,6 vezes do comprimento original, com posterior ganho de peso, redução do número de evacuações para uma exoneração ao dia e melhora da qualidade de vida social e psicológica. Conclusão -Essa técnica de inversão de segmento de alça intestinal e posterior STEP surge como tratamento eficiente e definitivo à síndrome do intestino curto de forma promissora e segura permitindo retorno à alimentação por via oral com satisfatória absorção de nutrientes e ganho de peso, retorno da motilidade efetiva intestinal, associada à baixa morbidade e melhoria da qualidade de vida social e psicológica. Apesar de requerer várias cargas de grampeadores lineares apresenta baixa morbidade e passa a tornar-se um potencial substituto para o transplante intestinal.ABSTRACT -Background -The short bowel syndrome results of inadequate total length of small intestine that is not enough to nutrition, and so, the patients become dependents of total parenteral nutrition. Numerous surgical strategies had been studied to reestablish the normal intestinal function. ObjectiveConsider the inversion segment of small intestine associated with STEP -Serial Transverse Enteroplasty -to increase the intestinal absorptive area in patients with short bowel syndrome. Method -The authors describe a new alternative for surgical treatment of short bowel syndrome, demonstrating it's easiness and efficiency for the considered objective. Results -The two techniques associated, had allowed lengthening the small intestine in 2,6 times the original length, with posterior profit of weight, reduction the number of evacuations. ConclusionThis technique of inversion segment of small intestine and posterior STEP is efficient, appears as definitive and promising technique of treatment to short bowel syndrome allowing return to oral feeding, with satisfactory absorption of nutrients, return to normal intestinal movement, associated to low morbidity and improvement the quality of social and psychological life. It presents low morbidity and is a potential substitute to intestinal transplant. INTRODUÇÃOA síndrome do intestino curto (SIC) resulta de um comprimento total de intestino delgado que é inadequado para manter a nutrição via oral sat...

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Small intestine transplantation today

Abstract: Thus, patients often present after onset of life-threatening complications or advanced cholestatic liver disease. Earlier timing of referral for candidacy might result in further improvement of this technique in the near future.

Cited by 15 publications

References 103 publications

FK506 treatment in a Long-term chronic rejection rat model of small bowel transplantation

FK506 treatment in a Long-term chronic rejection rat model of small bowel transplantation

Enteral Feeding as a Part of Combination Treatment in a Patient after Small Intestine Transplantation

Síndrome do intestino curto: uma nova alternativa de tratamento cirúrgico

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