Medstar Georgetown University Hospital, Medstar Georgetown Transplant Institute, 3800 Reservoir Road, Northwest, 2 PHC Building, Washington, DC 20007, USA.
Medstar Georgetown University Hospital, Medstar Georgetown Transplant Institute, 3800 Reservoir Road, Northwest, 2 PHC Building, Washington, DC 20007, USA.
Gastroenterol Clin North Am. 2018 Jun;47(2):341-354. doi: 10.1016/j.gtc.2018.01.011. Epub 2018 Apr 4.
Adult intestinal transplantation differs significantly from pediatric intestinal transplantation. While indications have remained largely consistent since 2000, indications for adults have expanded over the last two decades to include motility disorders and desmoid tumors. Graft type in adult recipients depends on the distinct anatomic characteristics of the adult recipient. Colonic inclusion, while initially speculated to portend unfavorable outcomes due to complex host-bacterial interactions has increased over the past two decades with superior graft survival and improved patient quality of life. Overall, outcomes have steadily improved. For adult intestinal transplant candidates, intestinal transplantation remains a mainstay therapy for complicated intestinal failure and is a promising option for other life threatening and debilitating conditions.
成人肠移植与儿科肠移植有很大的不同。虽然自 2000 年以来适应证基本保持一致,但在过去的二十年中,成人适应证已经扩大到包括运动障碍和硬纤维瘤。成人受者的移植物类型取决于成人受者的独特解剖特征。虽然最初推测由于复杂的宿主-细菌相互作用,结肠包含会导致不良结局,但在过去的二十年中,随着移植物存活率的提高和患者生活质量的改善,结肠包含的情况有所增加。总的来说,结果一直在稳步改善。对于成人肠移植候选者,肠移植仍然是复杂肠衰竭的主要治疗方法,并且对于其他危及生命和使人衰弱的疾病也是一种很有前途的选择。