Adult small intestinal transplantation in Europe

The results of clinical adult intestinal transplantation in eight European centres between 1988 and 1998 are presented. Data were available on a total of 29 transplants in 28 adult patients. Nine patients received ten isolated small intestinal grafts and a further 2 patients received grafts of small intestine and colon. Seventeen patients received multiviscerat grafts including small bowel. After 1994 all cases have received FK506 as their primary immunosuppressive agent, more recently increasingly often in combination with Mycophenolate. Ten out of twenty patients surviving more than one week after transplantation had no recorded episodes of rejection, five one episode of rejection, three two episodes of rejection and two three or more episodes. Eighteen patients have died, Sepsis being the cause of death in twelve of these cases. Actuarial survival figures for patients/grafts following isolated small intestinal transplantation are 64/53% at one year and 48/36% at three years following transplantation. Patient and graft survival are identical following multivisceral transplantation and are 44% at one year and 30% at three years in the thirteen patients managed under FK506 immunosuppression, none of the four patients transplanted under Cyclosporin therapy having survived beyond three months.