Intestinal transplantation is an option for individuals who are otherwise committed to a life of HPN because of intestinal failure. Intestinal transplantation is a fairly new procedure, which is still evolving, and at this time is still associated with significant risks. Rejection in intestinal transplantation is controllable with current immunosuppressive drugs, provided it is identified early. Infectious complications are the most significant cause of morbidity and mortality with intestinal transplantation. Post transplant lymphoproliferative disorders are also more common after intestinal transplantation, particularity when multivisceral transplants are performed. New strategies for detecting rejection and preventing infection are needed for intestinal transplantation to achieve the level of success that has been achieved with other solid organ transplants.


1. Carrel A. The transplantation of organs. A preliminary communication. J Am Med Assoc 1905; 45:1645.

2. Lillehei R, Goott B, Miller F. The physiological response of the small bowel of the dog to ischemia including prolonged in vitro preservation of the bowel with successful replacement and survival. Ann Surg 1959; 150:543.

3. Lillehei RC, Idezuki Y, Feemster JA et al. Transplantation of stomach, intestine, and pancreas: experimental and clinical observation. Surgery 1967; 62:721.

4. Margreiter R. The history of intestinal transplantation. Transpl Rev 1997; 11(1):9.

5. Cohen Z, Silverman R, Wassef R et al. Small intestine transplantation using cyclosporine. Report of a case. Transplantation 1986; 42:613.

6. Deltz E, Schroeder P, Gebhardt H et al. Successful clinical small bowel transplantation: report of a case. Clin Transplant 1989; 3:89.

7. Goulet O, Revillon, Jan D et al. Two and one-half-year follow-up after isolated cadaveric small bowel transplantation in an infant. Transplant Proc 1992; 24:1224.

8. Grant D, Wall W, Mimeault R et al. Successful small-bowel liver transplantation. Lancet 1990; 335:181.

9. McAllister VC, Grant DR. Clinical small bowel transplantation. In: Grant DR, Woods RFM, eds. Small Bowel Transplantation. Great Britain: Edward Arnold, 1994:121.

10. Grant DR. Intestinal Transplantation: 1997 report of the international registry. Transplantation 1999; 67(7):1061.

11. Scott N, Irving M. Intestinal Failure—the clinical problem. Dig Dis 1992; 10(5):249.

12. Nightingale J. The short bowel syndrome. Eur J Gastroenterol Hepatol 1995; 7(6):514.

13. Howard L, Ament M, Fleming R et al. Current use and clinical outcomes of home parenteral and enteral nutrition therapies in the United States. Gastroenterology 1995; 109:355.

14. Gruessner RW, Sharp HL. Living-related intestinal transplantation: first report of a standardized surgical technique. Transplantation 1997; 64(11):1605.

15. Schweizer E, Gassel A, Deltz E et al. A comparison of preservation solutions for small bowel transplantation in the rat. Transplantation 1994; 57(9):1406.

16. Scholten E, Manek G, Green C. A comparison of preservation solutions for long term storage in rat small bowel transplantation. Acta Chirurgica Austriaca 1992; 24:5.

17. Kusne S, Manez R, Frye B et al. Use of DNA amplification for diagnosis of cytomegalovirus enteritis after intestinal transplantation. Gastroenterology 1997; 112(4):1121.

18. Reyes J, Green M, Bueno J et al. Epstein Barr virus associated posttransplant lymphoproliferative disease after intestinal transplantation. Transplant Proc 1996; 28(5):2768.

19. Langnas A, Shaw B, Antonson D et al. Preliminary experience with intestinal transplantation in infants and children. Pediatrics 1996; 97(4):443.

20. Todo S, Tzakis A, Abu-Elmagd et al. Abdominal Multiviscereal Transplantation. Transplantation 1995; 59(2):234.

21. Spada M, Alessiani M, Fabbi M et al. Bacterial translocation is enhanced in pig intestinal transplantation when the colon is included in the graft. Transplant Proc 1996; 28(5):2658.

22. Tzakis A, Weppler D, Khan M et al. Mycophenolate mofetil as primary and rescue therapy in intestinal transplantation. Transplant Proc 1998; 30(6):2677.

23. Grant D, Lamont D, Zhong R et al. 51Cr-EDTA: a marker of early intestinal rejection in the rat. J Surg Res 1989; 46(5):507.

24. D'Alessandro AM, Kalayoglu M, Hammes R et al. Diagnosis of intestinal transplant rejection using technetium-99m-DTPA. Transplantation 1994; 58(1):112.

25. Lee RG, Nakamura K, Tsamandas AC et al. Pathology of human intestinal transplantation. Gastroenterology 1996; 110(6):1820.

26. Kusne S, Furukawa H, Abu-Elmagd et al. Infectious complications after small bowel transplantation in adults: and update. Transplant Proc 1996; 28(5):2761.

27. Bueno J, Green M, Kocoshis S et al. Cytomegalovirus infection after intestinal transplantation in children. Clin Infect Dis 1997; 25(5):1078.

28. Rowe DT, Qu L, Reyes J et al. Use of quantitative competitive PCR to measure Epstein-Barr virus genome load in the peripheral blood of pediatric transplant patients with lymphoproliferative disorders. J Clin Microbiol 1997; 35(6):1612.

29. Kim J, Fryer J, Craig RM. Absorptive function following intestinal transplantation. Dig Dis Sci 1998; 43(9):1925-30.

30. Fryer J, Kaplan B, Lown, K et al. Low bioavailability of cyclosporine microemulsion and tacrolimus in a small bowel transplant recipient. Transplantation 1999; 67(2):333.

31. Abu-Elmagd, Todo S, Tzakis A et al. Three years clinical experience with intestinal transplantation. J Am Coll Surg 1994; 179(4):385.

32. Todo S, Reyes J, Furukawa H et al. Outcome analysis of 71 clinical intestinal transplantations. Ann Surg 1995; 222(3):270.

33. Gruessner RW, Nakhleh RE, Harmon JV et al. Donor-specific portal blood transfusion in intestinal transplantation: a prospective, preclinical large animal study. Transplantation 1998; 66(2):164.

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