What Is a Small Bowel Transplant?
Small bowel transplantation is a highly experimental procedure and is only used in a small number of patients.
Small bowel transplantation
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- Chinese name
- Small bowel transplantation
- Nature
- A highly experimental step
- Apply to
- A small number of patients
- Ask a question
- Optimal length of small bowel segments for transplantation
- Small bowel transplantation is a highly experimental procedure and is only used in a small number of patients.
- These patients have impaired intestinal absorption epidermis due to intra-abdominal diseases such as torsional bowel, toxic enterocolitis, trauma. At present, small bowel transplantation should be limited to patients who cannot tolerate chronic parenteral nutrition, so there is no other option for survival. For the first time, it has been reported that after a small bowel transplant, the graft survives for more than one year and has full intestinal function. The question to be raised is the appropriate length of the small intestine segment for transplantation. The graft uses systemic vascular drainage, portal vein drainage, the suitability of graft continuity in the recipient's gastrointestinal tract, and the role of the allogeneic small intestinal donor lifestyle. Due to the presence of intestinal-associated lymphoid tissue, graft-to-host disease (GVHD) is a problem with small bowel transplantation, which is significantly larger than other allogeneic transplants with vascular organs. Removing cells that cause GVHD before transplanting the small intestine may also reduce The immunogenicity of the organs is an interesting experimental study.
- The concept of modern clinical small bowel transplantation is not limited to traditional small bowel transplantation in the traditional sense, but includes three types:
- 1. Small bowel transplantation alone;
- 2. Combined liver and small intestine transplantation: adapt to liver failure caused by intestinal failure combined with total parenteral nutrition (TPN);
- 3. Abdominal multi-organ transplantation: transplantation includes stomach, pancreas, duodenum, small intestine and liver.
- 1. Short bowel syndrome after extensive resection of the small intestine due to various reasons: including congenital small intestine atresia, extensive intestinal necrosis due to intestinal torsion, necrotizing enterocolitis, trauma, thrombosis or ischemia of mesenteric blood vessels or portal vein Extensive resection of the small intestine caused by repeated operations of Crohn's disease;
- 2. Gastrointestinal dysfunction: including chronic pseudointestinal obstruction, visceral neuropathy, and absence of ganglion cells in the digestive tract (Hirschsprung's disease);
- 3. Severe malabsorption due to congenital intestinal mucosal lesions, such as microvillus inclusion, tufting enteropathy;
- 4. Radioactive damage;
- 5. Difficult to control secretory diarrhea;
- 6. Autoimmune enteritis;
- 7. Congenital gastrointestinal malformations, such as fissures, congenital atresia of the small intestine;
- 8. Localized fibroblastoma;
- 9. Multiple polyposis, such as Gardner's syndrome;