Selvaggi Gennaro, Nishida Seigo, Levi David, Moon Jang, Island Eddie, Tekin Akin, Weppler Debbie, Tzakis Andreas
University of Miami, Miller School of Medicine, Miami Transplant Institute, Miami, Florida, USA.
Clin Transpl. 2009:211-7.
At the University of Miami Liver and GI Transplant Program, over 300 intestinal transplant procedures were performed in the last 15 years in adult and pediatric recipients. Good patient and graft survival rates are now achievable. Rejection remains the complication that is most difficult to prevent and manage. Induction with antilymphocyte agents, followed by maintenance with tacrolimus, is the preferred immunosuppression protocol at our center. We have expanded the use of multivisceral transplantation in pediatric recipients with short gut and significant liver dysfunction from parenteral nutrition. We also advocate the use of large intestine as part of the intestinal graft as well as inclusion of the spleen in multivisceral grafts, which in our experience can be safely accomplished. The future of intestinal transplantation lies in the use of noninvasive markers of intestinal rejection, and continued refinements in immunosuppression protocols.
在迈阿密大学肝脏与胃肠移植项目中，过去15年里为成人和儿童受者进行了300多例肠道移植手术。目前已能实现良好的患者和移植物存活率。排斥反应仍然是最难预防和处理的并发症。在我们中心，首选的免疫抑制方案是先用抗淋巴细胞药物诱导，然后用他克莫司维持。我们扩大了多脏器移植在因肠外营养导致短肠和严重肝功能不全的儿童受者中的应用。我们还提倡将大肠作为肠道移植物的一部分，并在多脏器移植物中纳入脾脏，根据我们的经验，这可以安全地完成。肠道移植的未来在于使用肠道排斥反应的非侵入性标志物，以及持续优化免疫抑制方案。
