Intestinal transplant outcome improves: 

            Intestinal transplantation is now the standard of therapy for patients with intestinal failure and complications resulting from total prenatal nutrition. The outcome after such transplantation has significantly improved thanks to refinements in surgical technique, patient selection and immunosuppressive protocols.

            Douglas Farmer and his colleagues at the Dumont University of California, Los Angles Transplant Center have the distinction of being one of the first centers to develop a comprehensive intestinal transplant program. A review of their 9 years’ (August 1991 to 2000) experience with intestinal transplantation appeared in the September 2001 issue of Archives of Surgery. A summary of their experience: 21 cadaveric intestinal grafts were transplanted into 17 patients (5 adults, 12 children) with intestinal failure due to long-term total parental nutrition. Patient survival at 1 and 3 years was 63% and 55% respectively, while “death censored” graft survival at 1 and 3 years was 73% and 55% respectively. The incidence of acute cellular rejection was “relatively low” at 1.5 episodes per graft, and only 3 grafts were lost due to rejection. Aggressive immunosuppressant, prophylaxis and preemptive therapy rendered infection due to Epstein-Barr virus and cytomegalo virus negligible.