Quigley E M
Department of Medicine, Cork University Hospital, Central Sciences Building, Cork, Ireland.
Curr Gastroenterol Rep. 2001 Oct;3(5):408-11. doi: 10.1007/s11894-001-0083-7.
The past few years have witnessed a considerable shift in the clinical status of intestinal transplantation. A great deal of experience has been gained at the most active centers, and results comparable with those reported at a similar stage in the development of other solid-organ graft programs are now being achieved by these highly proficient transplant teams. Rejection and its inevitable associate, sepsis, remain ubiquitous, and new immunosuppressant regimes are urgently needed; some may already be on the near horizon. The recent success of isolated intestinal grafts, together with the mortality and morbidity attendant upon the development of advanced liver disease related to total parenteral nutrition, has prompted the bold proposal that patients at risk for this complication should be identified and should receive isolated small bowel grafts before the onset of end-stage hepatic failure. The very fact that such a suggestion has begun to emerge reflects real progress in this challenging field.
在过去几年中，肠道移植的临床状况发生了相当大的转变。一些最活跃的移植中心积累了丰富的经验，这些技术娴熟的移植团队目前所取得的成果，已与其他实体器官移植项目在类似发展阶段所报告的成果不相上下。排斥反应及其不可避免的伴发症——脓毒症，仍然普遍存在，因此迫切需要新的免疫抑制方案；有些方案可能已近在眼前。近期，孤立小肠移植取得成功，再加上全胃肠外营养引发的晚期肝病所带来的死亡率和发病率，促使人们大胆提出，应识别出有这种并发症风险的患者，并在终末期肝衰竭发生之前为其进行孤立小肠移植。这样的建议开始出现这一事实，反映了在这个充满挑战的领域取得的实际进展。
