Intestinal transplantation in composite visceral grafts or alone.
Intestinal transplantation in composite visceral grafts or alone.
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肠移植采用复合内脏移植物或单独移植。
DOI：
10.1097/00000658-199209000-00002
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发表时间：
1992
影响因子：
9
通讯作者：
Fung,JJ
中科院分区：
文献类型：
--
作者：
Todo,S;Tzakis,AG;Abu-Elmagd,K;Reyes,J;Nakamura,K;Casavilla,A;Selby,R;Nour,BM;Wright,H;Fung,JJ
在基于FK 506的免疫抑制下，除了几个近端和远端厘米之外的整个尸体小肠被转移到17个随机匹配的患者，其中两个具有抗移植物细胞毒性抗体（阳性交叉匹配）。8例患者仅接受肠移植，8例患者的肠与肝脏相连，1例患者接受了包括肝脏、胃和胰腺在内的完整多脏器移植。1例肝肠联合移植受者在肠吻合口瘘、败血症和移植物抗宿主病后死亡。其他16例患者在1至23个月后存活，其中1例在慢性排斥、移植物取出和再次移植后存活。12例患者已从全肠外营养中解放出来，包括所有移植2个月或更长时间的患者。移植物支持良好的营养，并在儿童中，允许生长和体重增加。这些患者的管理一直是困难的，往往是复杂的，但在大多数情况下，最终结果是令人满意的，证明进一步的临床试验。8例仅接受小肠移植的患者的恢复比肝肠或多脏器移植更快，更容易，在控制排斥反应方面没有更大的困难。图像
Under FK 506-based immunosuppression, the entire cadaver small bowel except for a few proximal and distal centimeters was translated to 17 randomly matched patients, of whom two had antigraft cytotoxic antibodies (positive cross-match). Eight patients received the intestine only, eight had intestine in continuity with the liver, and one received a full multivisceral graft that included the liver, stomach, and pancreas. One liver-intestine recipient died after an intestinal anastomotic leak, sepsis, and graft-versus-host disease. The other 16 patients are alive after 1 to 23 months, in one case after chronic rejection, graft removal, and retransplantation. Twelve of the patients have been liberated from total parenteral nutrition, including all whose transplantation was 2 months or longer ago. The grafts have supported good nutrition, and in children, have allowed growth and weight gain. Management of these patients has been difficult and often complicated, but the end result has been satisfactory in most cases, justifying further clinical trials. The convalescence of the eight patients receiving intestine only has been faster and more trouble free than after liver-intestine or multivisceral transplantation, with no greater difficulty in the control of rejection. Images