scholarly journals Pediatric intestinal transplantation: Analysis of the intestinal transplant registry

2019 ◽  
Vol 23 (8) ◽  
Author(s):  
Vikram K. Raghu ◽  
Jennifer L. Beaumont ◽  
Matthew J. Everly ◽  
Robert S. Venick ◽  
Florence Lacaille ◽  
...  
Keyword(s):  
Intestinal Transplantation ◽  
Transplant Registry ◽  
Intestinal Transplant

Impact of pediatric intestinal transplantation on intestinal failure in Japan: findings based on the Japanese intestinal transplant registry

2013 ◽  
Vol 29 (10) ◽  
pp. 1065-1070 ◽  
Author(s):  
Takehisa Ueno ◽  
Motoshi Wada ◽  
Ken Hoshino ◽  
Shinji Uemoto ◽  
Tomoaki Taguchi ◽  
...  
Keyword(s):  
Intestinal Failure ◽  
Intestinal Transplantation ◽  
Transplant Registry ◽  
Intestinal Transplant

Results and trends in intestinal transplantation: 2013 International Intestinal Transplant Registry

2014 ◽  
Vol 28 (2) ◽  
pp. 121
Author(s):  
L.J. Ceulemans ◽  
D. Monbaliu ◽  
G. Van Helleputte ◽  
I.H. Hundscheid ◽  
K. Lenaerts ◽  
...  
Keyword(s):  
Intestinal Transplantation ◽  
Transplant Registry ◽  
Intestinal Transplant

scholarly journals Intestinal Transplant Registry Report: Global Activity and Trends

2014 ◽  
Vol 15 (1) ◽  
pp. 210-219 ◽  
Author(s):  
D. Grant ◽  
K. Abu-Elmagd ◽  
G. Mazariegos ◽  
R. Vianna ◽  
A. Langnas ◽  
...  
Keyword(s):  
Transplant Registry ◽  
Intestinal Transplant ◽  
Registry Report ◽  
Global Activity

scholarly journals PU.1-Silenced Dendritic Cells Induce Mixed Chimerism and Alleviate Intestinal Transplant Rejection in Rats via a Th1 to Th2 Shift

2016 ◽  
Vol 38 (1) ◽  
pp. 220-228 ◽  
Author(s):  
Xingwei Xu ◽  
Xin Gao ◽  
Xiaofan Zhao ◽  
Yannian Liao ◽  
Wu Ji ◽  
...  
Keyword(s):  
Dendritic Cells ◽  
Transplant Rejection ◽  
Intestinal Transplantation ◽  
Mixed Chimerism ◽  
Brown Norway ◽  
Post Transplantation ◽  
Intestinal Transplant ◽  
End Stage ◽  
Graft Morphology ◽  
Norway Rats

Background/Aims: Intestinal transplantation is an effective treatment for end-stage bowel failure; however, graft rejection and the toxicity associated with non-specific immunosuppression are major limitations of this procedure. Studies have shown that mixed chimerism can produce post-transplantation immune tolerance. Here, we demonstrate that in rat intestinal transplantation, PU.1-silenced dendritic cells (DCs) plus bone marrow (BM) cell transfusion results in mixed chimerism, and we investigate the mechanisms responsible for the effects of mixed chimerism rejection. Methods: In a model of intestinal transplantation, male Brown Norway rats were the donors, and female Lewis rats were the recipients that were randomly divided into 4 groups: control, BM, BM-imDCs and BM-PU.1. The dynamic changes in graft morphology, rejection scoring and serum concentrations of Th1/Th2-related cytokines were investigated on postoperative days 0, 7, 14, 21, and 30. Results: The BM-PU.1 group had better graft health, milder pathologic injuries, and lower rejection grades compared with the other groups. The rates of mixed chimerism were significantly highest in the BM-PU.1 group and correlated with decreases in serum IL-2 and increases in serum IL-10. Conclusion: Transfusion of PU.1-silenced DCs and BM cells induces stable mixed chimerism and has the potential to reduce pathologic injuries via a pro-Th2 shift in the Th1/Th2 balance.

Small Intestinal and Multivisceral Transplantation

2016 ◽  
Author(s):  
Bernard J. DuBray ◽  
Douglas G. Farmer
Keyword(s):  
Parenteral Nutrition ◽  
Graft Survival ◽  
Intestinal Failure ◽  
Intestinal Transplantation ◽  
Nutrition Therapy ◽  
Transplant Recipients ◽  
En Bloc ◽  
Multivisceral Transplantation ◽  
Rehabilitation Programs ◽  
Intestinal Transplant

The role of transplantation in the management of intestinal failure continues to evolve. Since the development of parenteral nutrition in the late 1960s, permanent intestinal failure has been medically managed with visceral transplantation, reserved for those who develop life-threatening complications. A multidisciplinary approach to intestinal care has led to the emergence of intestinal rehabilitation programs that have successfully achieved nutritional autonomy for many individuals through the promotion of adaptation. Whereas the short-term results of visceral transplantation have improved dramatically to the level of other solid organs, durable long-term graft survival has been elusive. This review covers intestinal failure, epidemiology, intestinal and multivisceral transplantation, and the future of intestinal and multivisceral transplantation. Figures show the embryonic origin of the multivisceral allograft, en bloc retrieval of the intestinal allograft, preparation for engraftment, vascularization of the isolated intestinal allograft, enteric reconstruction of the intestinal allograft, the liver-intestine allograft, preparation for liver-intestine engraftment, the modified multivisceral graft, arterial reconstruction in modified multivisceral transplantation, vascularization of the modified multivisceral allograft, recipient preparation in modified multivisceral transplantation, intestinal alloreactivity, graft survival among intestinal transplant recipients, patient survival among intestinal transplant recipients, candidates waiting for an intestine transplant, and distribution of candidates waiting for intestinal transplantation. Tables list causes of intestinal failure, predictors of outcome in intestinal failure, failure of total parenteral nutrition therapy as defined by the Centers for Medicare and Medicaid Services, histologic grading of acute cellular rejection, and criteria for chronic rejection in visceral allografts.   This review contains 16 highly rendered figures, 5 tables, and 54 references.

scholarly journals The Long and Short of IT: intestinal failure-associated liver disease (IFALD) in adults—recommendations for early diagnosis and intestinal transplantation

2019 ◽  
Vol 11 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Jeremy Mark Woodward ◽  
Dunecan Massey ◽  
Lisa Sharkey
Keyword(s):  
Liver Disease ◽  
Advanced Disease ◽  
Intestinal Failure ◽  
Intestinal Transplantation ◽  
Recent Experience ◽  
High Grade ◽  
Donor Liver ◽  
Non Invasive ◽  
Intestinal Transplant ◽  
Intestine Transplantation

Intestinal failure-associated liver disease (IFALD) often presents in adults unexpectedly with advanced disease. Non-invasive tests can be falsely reassuring. Patients with ‘ultrashort’ intestine (<20 cm) ending in a stoma are at particular risk of developing IFALD, which may occur rapidly. Recent experience and studies suggest that IFALD can be reversed by isolated intestine transplant occurring before the development of high grade fibrosis or cirrhosis. Post-transplant survival is superior for isolated intestinal grafts compared with liver containing intestinal grafts; waiting time and waiting list mortality is higher for a combined graft, and donor liver supply is limited. Therefore, the aim of clinicians treating patients with intestinal failure should be to identify IFALD early and refer to an intestinal transplant centre while isolated intestine transplantation can be contemplated and before the liver disease has progressed to a stage requiring consideration of combined liver and intestinal transplantation.

Is There a Role for Desensitization in Intestinal Transplantation?

2019 ◽  
Vol 29 (3) ◽  
pp. 275-278
Author(s):  
Andrew D. Santeusanio ◽  
Jang Moon ◽  
Vinay Nair ◽  
Kishore R. Iyer
Keyword(s):  
Therapeutic Option ◽  
Graft Loss ◽  
Human Leukocyte ◽  
Intestinal Transplantation ◽  
Leukocyte Antigen ◽  
Desensitization Therapy ◽  
Early Graft ◽  
Desensitization Protocol ◽  
Transplant Candidates ◽  
Intestinal Transplant

Human leukocyte antigen allosensitization prior to transplant can increase the risk of early graft loss and prolong waitlist times for intestinal transplant candidates. Desensitization offers a potential therapeutic option to reduce the quantity of preformed antibodies prior to organ allocation and facilitate transplantation with a more immunologically compatible donor allograft. However, there remains a paucity of data to guide the use of desensitization in the setting of intestinal transplantation. As a result, in this review we evaluate the existing literature supporting the role of desensitization therapy in intestinal transplant, describe our own experience with the implementation of a risk-stratified desensitization protocol, and finally explore barriers and unanswered questions that continue to limit the widespread adoption of desensitization as a management strategy for highly sensitized intestinal transplant candidates.

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