Small bowel transplantation

Many patients die each year lacking only a functional small bowel to surviv e. The minimum amount of small intestinal absorptive surface required to su stain life varies from patient to patient. Prolonged survival with oral ali mentation alone has been reported in a few patients with an intact duodenum and as little as 15-45 cm of residual jejunum. However, without long-term total parenteral nutrition (TPN), prolonged patient survival is the excepti on rather than the rule.(1) Chronic parenteral nutrition is associated with complications, including se psis, venous thrombosis, metabolic disorders and liver dysfunction.(2) From studies of patients currently on long-term TPN, it would appear that there are between two and three patients per million of population per year who develop irreversible small bowel failure.(3) It is estimated that 20 new pa tients/year in the UK receiving home TPN would be potential candidates for small bowel transplantation.(1).