Benedetti E, Baum C, Cicalese L, Brown M, Raofi V, Massad M G, Abcarian H
Department of Surgery, University of Illinois at Chicago, 60612, USA.
Transplantation. 2001 Feb 27;71(4):569-71. doi: 10.1097/00007890-200102270-00014.
We report a patient with short gut syndrome successfully treated with living related bowel transplantation. A 27-year-old Caucasian man was referred after traumatic loss of almost the entire bowel from the third portion of duodenum to the sigmoid colon. His HLA-identical sister volunteered as a donor. A 200-cm segment of ileum was successfully transplanted under tacrolimus-based immunosuppression. The posttransplant course was uneventful, without rejection or infectious complication. Total parenteral nutrition was discontinued 1 week posttransplant. At 6 months the patient had returned to his preinjury weight. Water and D-xylose absorption as well as fecal fat studies were markedly abnormal 1 month posttransplant but normalized by 6 months. The donor recovery was uneventful. A well-matched segmental ileal graft from living donor can provide complete rehabilitation for patients with short gut syndrome. We documented a progressive functional adaptation of the ileal graft, resulting in normal absorption by 5 months posttransplantation.
我们报告了一例通过亲属活体肠移植成功治疗短肠综合征的患者。一名27岁的白种男性在遭受创伤后，从十二指肠第三段至乙状结肠几乎整个肠道缺失，随后前来就诊。他 HLA 配型相同的姐姐自愿作为供体。在以他克莫司为基础的免疫抑制治疗下，成功移植了一段200厘米长的回肠。移植后的过程顺利，未出现排斥反应或感染并发症。移植后1周停止了全肠外营养。6个月时，患者恢复到受伤前的体重。移植后1个月，水和 D -木糖吸收以及粪便脂肪研究明显异常，但到6个月时恢复正常。供体恢复顺利。来自活体供体的匹配良好的节段性回肠移植物可为短肠综合征患者提供完全康复。我们记录了回肠移植物逐渐的功能适应过程，移植后5个月吸收功能恢复正常。
