Berney T, Genton L, Buhler L H, Raguso C A, Charbonnet P, Pichard C, Morel P
Department of Visceral and Transplantation Surgery, Geneva University Hospitals, Geneva, Switzerland.
Transplant Proc. 2004 Mar;36(2):316-8. doi: 10.1016/j.transproceed.2004.01.103.
Two 13-year-old monozygotic twins were used for living related small bowel transplantation (SBTx). The recipient presented with short gut syndrome secondary to complicated abdominal surgery. The indication for SBTx was based on a failure to thrive and a poor tolerance of TPN. The donor was an identical twin, as demonstrated by skin graft acceptance, which allowed performance of SBTx without immunosuppression. Growth charts were used to follow intestinal absorption functions and body composition. The donor was used as a control for the recipient. The recipient, who was transplanted with 160 cm of donor ileum, was discharged on postoperative day 62 on a regular diet. Before SBTx the recipient was 10 kg lighter in body weight than the donor, a gap that was progressively reduced over the follow-up period. A height deficit of 3 cm reversed within 1 year after SBTx. A 10-kg deficit in fat-free body mass was completely extinguished within 18 months. By 18 months posttransplant, recipient serum albumin and prealbumin were normal and comparable to donor values. d-Xylose absorption in the recipient remained lower than that in the donor. Within 6 months fecal fat excretion normalized in the recipient. d-Xylose absorption and fecal fat excretion were always within a normal range in the donor.
两名13岁的同卵双胞胎被用于活体亲属小肠移植（SBTx）。受者因复杂的腹部手术继发短肠综合征。SBTx的指征基于生长发育不良和对全胃肠外营养（TPN）耐受性差。供者为同卵双胞胎，皮肤移植相容性试验证实了这一点，这使得SBTx在无需免疫抑制的情况下得以进行。使用生长图表来跟踪肠道吸收功能和身体组成。将供者作为受者的对照。接受了160厘米供者回肠移植的受者在术后第62天出院，开始正常饮食。在SBTx之前，受者的体重比供者轻10千克，在随访期间这个差距逐渐缩小。3厘米的身高差距在SBTx后1年内逆转。10千克的去脂体重差距在18个月内完全消除。移植后18个月时，受者的血清白蛋白和前白蛋白正常，与供者的值相当。受者的d-木糖吸收仍低于供者。受者在6个月内粪便脂肪排泄恢复正常。供者的d-木糖吸收和粪便脂肪排泄始终在正常范围内。
