[Living-related small bowel transplantation: report of 2 cases].

OBJECTIVE

To investigate the result in treating short bowel syndrome with living-related small bowel transplantation.

METHODS

Two patients with short bowel syndrome underwent living-related small bowel transplantation. One patient was an 18-year-old boy and the donor was his father. A segment of 150 cm distal small bowel was resected as the graft from the donor. Another patient was a 15-year-old boy and the donor was his mother. The graft was 160 cm long, with arteries and veins anastomosed to the recipient's infrarenal aorta and cava respectively. Intestinal continuity was restored with an end-to-end anastomosis between the recipient's jejunum and the donor's ileum, and the distal end was made as fistulization. Treatment of immunosuppression, antibiotics, anti-thrombosis and nutritional support were given posttransplantation.

RESULTS

Complications such as anaemia and acute rejection occurred in the first recipient and were handled properly and brought under control after operation. The patient has been surviving 26 months since the transplantation. The graft's function is well. The patient can eat food and resume his daily work. In the second recipient, acute rejection occurred on day 26 after operation and was controlled by implosion therapy. Serious rejection occurred on day 80 again and did not respond to implosion therapy with methylprednisolone. After use of OKT3 and ATG the rejection was minimized. Because of uncontrolled infection, the patient died on 5th month after operation.

CONCLUSION

Living-related small bowel transplantation is an ideal treatment for short bowel syndrome.