Middleton S J, Pollard S, Friend P J, Watson C, Calne R Y, Davies M, Cameron E A B, Gimson A E, Bradley J A, Shaffer J, Jamieson N V
Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, UK.
Br J Surg. 2003 Jun;90(6):723-7. doi: 10.1002/bjs.4095.
In 1996 two transplantation centres in the UK were commissioned by the National Specialist Commissioning Advisory Group for England and Wales to assess small intestinal transplantation in adults. The joint experience of the two centres is presented.
Patients with irreversible small intestinal failure and complications of parenteral nutrition, and those with abdominal disease requiring extensive visceral resection, were assessed as candidates and where appropriate listed for surgery.
Thirty-six patients were assessed for small intestinal transplantation and, of these, 14 underwent surgery. Twelve patients survived the transplantation procedure. Of these, seven patients were alive at 1 year, five at 3 years and three at 5 years. Three patients remain alive. Patient and graft survival improved with experience; the 1-year survival rate improved in the last 4 years of this experience from 43 to 57 per cent, and the 3-year survival rate from 29 to 43 per cent.
Small intestinal transplantation is associated with a high mortality rate but may benefit carefully selected patients in whom conservative management is likely to carry a greater mortality rate.
1996年，英国的两个移植中心受英格兰和威尔士国家专科委托咨询小组的委托，对成人小肠移植进行评估。本文介绍了这两个中心的联合经验。
对患有不可逆小肠衰竭和肠外营养并发症的患者，以及患有需要广泛内脏切除的腹部疾病的患者进行评估，确定其是否为手术候选者，并在适当时将其列入手术名单。
对36例患者进行了小肠移植评估，其中14例接受了手术。12例患者在移植手术后存活。其中，7例患者在1年时存活，5例在3年时存活，3例在5年时存活。3例患者仍存活。随着经验的积累，患者和移植物的存活率有所提高；在这段经验的最后4年中，1年存活率从43%提高到57%，3年存活率从29%提高到43%。
小肠移植的死亡率很高，但对于精心挑选的患者可能有益，因为保守治疗可能会带来更高的死亡率。
