SMALL-BOWEL TRANSPLANTATION - EXPERIMENTAL AND CLINICAL-RESULTS

The intestine was one of the first organs to be successfully transplanted experimentally. Results in humans were disappointing until recently, partly due to the large quantity of lymphoid tissue present in the intestine, resulting in a vigorous rejection process which is difficult to control. Recent advances in experimental studies have improved our knowledge about mechanisms of rejection and graft-versus-host disease, and have allowed the development of new immunosuppressive therapies. At the present time, major obstacles remain in clinical intestinal transplantation (i.e. difficulty of preventing rejection despite massive immunosuppression, high rate of postoperative sepsis). However, the protective effect of a concomitant transplanted liver and the use of FK 506 have allowed a dramatic improvement in clinical results, justifying continuation of experimentation of intestinal transplantation in humans.