Progressive functional adaptation of segmental, bowel graft from living related donor

We report a patient with short gut syndrome successfully treated with livin g related bowel transplantation. A 27-year-old Caucasian man was referred a fter traumatic loss of almost the entire bowel from the third portion of du odenum to the sigmoid colon, His HLA-identical sister volunteered as a dono r. A 200-cm segment of ileum was successfully transplanted under tacrolimus -based immunosuppression. The posttransplant course was uneventful, without rejection or infectious complication. Total parenteral nutrition was disco ntinued 1 week posttransplant. At 6 months the patient had returned to his preinjury weight. Water and D-xylose absorption as well as fecal fat studie s were markedly abnormal 1 month posttransplant but normalized by 6 months. The donor recovery was uneventful. A well-matched segmental ileal graft fr om living donor can provide complete rehabilitation for patients with short gut syndrome. We documented a progressive functional adaptation of the ile al graft, resulting in normal absorption by 5 months posttransplantation.