SMALL-BOWEL TRANSPLANTATION - A LIFESAVING OPTION FOR SELECTED PATIENTS WITH INTESTINAL FAILURE

Thirty-seven patients were listed for small bowel transplantation; 16 were transplanted and 15 died while waiting for a donor. Cyclosporine (N = 6) or tacrolimus (N = 10) were used for immune suppression. Graft rejection rates were lower in the combined liver/small bowel grafts t han the isolated intestinal transplants (1/7 vs 5/7; P < 0.01) All of the cyclosporine group have died; the median survival was 25.7 months with two patients living more than five years; The tacrolimus group ha d fewer infections and a shorter hospital stay, All but two are alive with a median survival of 13 months. Seven of eight long-term survivor s are off intravenous feedings. We conclude that small bowel transplan tation is a life-saving option for patients with intestinal failure wh o cannot be maintained on total parenteral nutrition.