Intestine transplantation

An intestine transplant may involve the use of an entire intestine or just a shortened segment. Most intestine transplants completed in the United States have involved the transplant of the full organ and often are performed in conjunction with a liver transplant. Although most intestine transplants involve organs harvested from a deceased donor, recent advances in the field now have made it possible for living-donor intestinal segment transplants. There were 178 intestinal transplant recipients (171 deceased donors, 7 living donors) in 2005.3... 

Intestine Fever and Gl symptoms (e.g., bloating, cramping, diarrhea, increased stomal output) There are no reliable biochemical markers for intestine transplant rejection, but biopsies may be helpful... 

The mRNA expression of PEPT1 varies significantly in response to several chemical factors. The expression of the transporter was upregulated by substrates [89, 90], diet [91, 92], insulin [93], a2-adrenergic agonists [93], and pentazocine [94]. While it has been reported that intestinal transplantation [89, 95], cAMP [96], epidermal growth factor [97], and thyroid hormone [98] inhibited the expression of PEPT1. 

Chehade, M., Nowak-Wegrzyn, A., Kaufman, S. S., Fishbein, T. M., Tschemia, A., and FeFeiko, N. S. (2004). De novo food allergy after intestinal transplantation A report of three cases. /. Pediatr. Gastroenterol. Nutr. 38, 545-547. 

Intestinal transplantation is combined with liver transplantation in 46% of cases, because of terminal liver failure (93). Of 78 patients who had received parenteral nutrition for more than 2 years n — 66) and/ or had short bowel syndrome and could not be weaned from parenteral nutrition (n = 12), 58 developed chronic cholestasis and 37 developed one or more severe liver complication (serum bilirubin concentration 60 pmol/l, factor V (proaccelerin) 50%, portal hypertension, encephalopathy, ascites, bleeding from the gastrointestinal tract, or histological findings consisting of extensive fibrosis and cirrhosis) after 6 (3-132) months and 17 (2-155) months respectively. Liver disease was responsible for deaths in 6.5% of the patients (22% of deaths). 

Attempts to minimize TAC-induced renal dysfunction by TAC switch to sirolimus [419, 744, 745] or use of low-dose maintenance TAC therapy associated with lymphocyte depleting agents, mycophenolate mofetil or sirolimus have been successfully achieved [746-750]. However, the association of TAC and sirolimus does not seem to be problem-free. Severe acute kidney injury in renal transplant recipients and thrombotic microangiopathy in intestinal transplant have been associated to combined use of TAC and sirolimus [751, 752], renal function improved in renal transplant recipients after conversion from TAC/ sirolimus to TAC/MMF therapy [753] and TAC/sirolimus combination was associated to worst renal allograft survival than TAC/MMF im-... 

Paramesh AS, Grosskreutz C, Florman SS, Gondolesi GE, Sharma S, Kaufman SS, Fishbein TM.Thrombotic microangiopathy associated with combined sirolimus and tacrolimus immunosuppression after intestinal transplantation. Transplantation 2004 77 129-131. 

Berney T, Dehs S, Kato T, et al. Successful treatment of post-transplant lymphoproliferative disease with prolonged rituximab treatment in intestinal transplant recipients. Transplantation 2002 74 1000-1006. 

Langnas AN, Shaw BW, Antonson DL, et al. Preliminary experience with intestinal transplantation in infants and children. Pediatrics 1996 97 443— 448. 

Grant D. Intestinal transplantation 1997 report of the international registry. Intestinal Transplant Registry. Transplantation 1999 67 1061-1064. 

Goulet O, et al. Intestinal transplantation Indications, results and strategy. Curr Opin Clin Nutr Metab Care 2000 3 329-338. 

Deutsch AA, Arensman R, Levey R, Folkman J. The effect of antilymphocyte serum on fetal rat intestine transplanted as free subcutaneous homografts. J. Pediatr. Surg. 1974 9 29-34. 

Many etiologies for protein-losing enteropathies (celiac disease, intestinal lymphangiectasis, allergic gastroenteritis, cow milk protein allergy, Crohn disease, cystic fibrosis, collagen vascular disease, short bowel, intestinal transplants and others) have been identified. 

Puestow, C.B. 1933. Studies on the origins of the automaticity of the intestine the action of certain drugs on isolated intestinal transplants. Am. J. Physiol, 106 682-688. 

Deltz, E., Schroeder, R, Gebhardt, H., Gundlach, M., Engemann, R., Timmermann, W., 1989. First successful clinical small intestine transplantation. Tactics and surgical technic. Chirurg 60 (4), 235-239. 

Kiyochi, H., Ono, A., Yamamoto, N., Ohnishi, K., Shimahara, Y., and Kobayashi, N., Extrinsic sympathetic reinnervation after intestinal transplantation in rats, Tran.splan-tation, 59. 328-333 (1995). 

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