Segmental small-intestinal transplantation: a comparison of jejunal and ileal grafts.
Segmental small-intestinal transplantation: a comparison of jejunal and ileal grafts.
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DOI：
10.1067/msy.2002.119962
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发表时间：
2002
期刊：
影响因子：
3.8
通讯作者：
T. Taguchi;S. Suita
中科院分区：
文献类型：
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作者：
T. Taguchi;S. Suita
强烈的免疫反应，如排斥反应和移植物抗宿主病，一直是实现成功的肠道移植的主要障碍。部分小肠移植被认为比全长移植反应更弱。从活体供体中获取器官的问题和接受者腹腔的空间限制是需要进行节段性小肠移植的另一个原因。选择最合适的肠段用于移植也很重要；因此，本文从原生肠的特性、功能、保存和免疫反应等方面对空肠和回肠移植进行比较综述。免疫学上，空肠被认为比回肠略胜一筹。然而，对于回肠移植物来说，排异反应的控制并没有变得异常困难。在功能上，回肠被认为在几个参数方面更好，如更大的脂肪、胆汁酸和维生素的吸收能力和适应潜力。解剖学上，回肠移植物是可行的活体移植。然而，对于选择回肠作为合适的节段移植物，尚无决定性因素。还需要进一步的广泛研究来阐明肠移植的各种实验和临床方面。
Strong immune responses, such as rejection and graft-versus-host disease, have been major obstacles to achieving a successful intestinal transplantation. Segmental small-intestinal transplantation is considered to result in a weaker response than total length grafting. Problems relating to organ harvesting from a living donor and spacial constraints of the recipient's abdominal cavity are the other reasons why a segmental small intestinal transplantation is required. It is also important to select the most suitable part of the intestine to be used in transplantation; therefore, the jejunal and ileal grafts were comparatively reviewed from the aspects of native bowel characteristics, function, preservation, and immunological response. Immunologically, the jejunum is considered to have a slight advantage over the ileum. However, the control of rejection does not become inordinately more difficult for ileal grafts. Functionally, the ileum is considered to be better with regard to several parameters, such as greater absorptive capacities of fat, bile acids, and vitamins, and adaptation potential. Anatomically, an ileal graft is feasible for living-related transplantation. However, there is no conclusive factor for choosing the ileum as a suitable segmental graft. Further extensive studies are still needed to clarify various experimental as well as clinical aspects regarding intestinal transplantation.