Intestinal transplantation in composite visceral grafts or alone

S. Todo, A. G. Tzakis, K. Abu-Elmagd, J. Reyes, K. Nakamura, A. Casavilla, R. Selby, Bakr Nour, H. Wright, J. J. Fung, A. J. Demetris, D. H. Van Thiel, T. E. Starzl, R. W. Busuttil, F. T. Rapaport, L. O. Vasconez, J. C. Thompson, B. W. Shaw

Research output: Contribution to journalArticle

201 Citations (Scopus)

Abstract

Under FK 506-based immunosuppression, the entire cadaver small bowel except for a few proximal and distal centimeters was translated to 17 randomly matched patients, of whom two had antigraft cytotoxic antibodies (positive cross-match). Eight patients received the intestine only, eight had intestine in continuity with the liver, and one received a full multivisceral graft that included the liver, stomach, and pancreas. One liver-intestine recipient died after an intestinal anastomotic leak, sepsis, and graft- versus-host disease. The other 16 patients are alive after 1 to 23 months, in one case after chronic rejection, graft removal, and retransplantation. Twelve of the patients have been liberated from total parenteral nutrition, including all whose transplantation was 2 months or longer ago. The grafts have supported good nutrition, and in children, have allowed growth and weight gain. Management of these patients has been difficult and often complicated, but the end result has been satisfactory in most cases, justifying further clinical trials. The convalescence of the eight patients receiving intestine only has been faster and more trouble free than after liver-intestine or multivisceral transplantation, with no greater difficulty in the control of rejection.

Original languageEnglish
Pages (from-to)223-234
Number of pages12
JournalAnnals of Surgery
Volume216
Issue number3
Publication statusPublished - 1992
Externally publishedYes

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Transplantation
Intestines
Transplants
Liver
Anastomotic Leak
Total Parenteral Nutrition
Graft Rejection
Tacrolimus
Graft vs Host Disease
Cadaver
Immunosuppression
Weight Gain
Pancreas
Sepsis
Stomach
Clinical Trials
Antibodies
Growth

ASJC Scopus subject areas

  • Surgery

Cite this

Todo, S., Tzakis, A. G., Abu-Elmagd, K., Reyes, J., Nakamura, K., Casavilla, A., ... Shaw, B. W. (1992). Intestinal transplantation in composite visceral grafts or alone. Annals of Surgery, 216(3), 223-234.

Intestinal transplantation in composite visceral grafts or alone. / Todo, S.; Tzakis, A. G.; Abu-Elmagd, K.; Reyes, J.; Nakamura, K.; Casavilla, A.; Selby, R.; Nour, Bakr; Wright, H.; Fung, J. J.; Demetris, A. J.; Van Thiel, D. H.; Starzl, T. E.; Busuttil, R. W.; Rapaport, F. T.; Vasconez, L. O.; Thompson, J. C.; Shaw, B. W.

In: Annals of Surgery, Vol. 216, No. 3, 1992, p. 223-234.

Research output: Contribution to journalArticle

Todo, S, Tzakis, AG, Abu-Elmagd, K, Reyes, J, Nakamura, K, Casavilla, A, Selby, R, Nour, B, Wright, H, Fung, JJ, Demetris, AJ, Van Thiel, DH, Starzl, TE, Busuttil, RW, Rapaport, FT, Vasconez, LO, Thompson, JC & Shaw, BW 1992, 'Intestinal transplantation in composite visceral grafts or alone', Annals of Surgery, vol. 216, no. 3, pp. 223-234.
Todo S, Tzakis AG, Abu-Elmagd K, Reyes J, Nakamura K, Casavilla A et al. Intestinal transplantation in composite visceral grafts or alone. Annals of Surgery. 1992;216(3):223-234.
Todo, S. ; Tzakis, A. G. ; Abu-Elmagd, K. ; Reyes, J. ; Nakamura, K. ; Casavilla, A. ; Selby, R. ; Nour, Bakr ; Wright, H. ; Fung, J. J. ; Demetris, A. J. ; Van Thiel, D. H. ; Starzl, T. E. ; Busuttil, R. W. ; Rapaport, F. T. ; Vasconez, L. O. ; Thompson, J. C. ; Shaw, B. W. / Intestinal transplantation in composite visceral grafts or alone. In: Annals of Surgery. 1992 ; Vol. 216, No. 3. pp. 223-234.
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AU - Tzakis, A. G.

AU - Abu-Elmagd, K.

AU - Reyes, J.

AU - Nakamura, K.

AU - Casavilla, A.

AU - Selby, R.

AU - Nour, Bakr

AU - Wright, H.

AU - Fung, J. J.

AU - Demetris, A. J.

AU - Van Thiel, D. H.

AU - Starzl, T. E.

AU - Busuttil, R. W.

AU - Rapaport, F. T.

AU - Vasconez, L. O.

AU - Thompson, J. C.

AU - Shaw, B. W.

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