de Bruin R W, Heineman E, Marquet R L
Department of General Surgery, Erasmus University, Rotterdam, The Netherlands.
Transpl Int. 1994;7(1):47-61. doi: 10.1007/BF00335664.
Small bowel transplantation (SBT) would, in theory, be the treatment of choice for patients suffering from the short bowel syndrome. Although SBT has been done with a considerable degree of success in some centers [36, 145], it is by no means an established or widely applicable therapy for those with short bowel syndrome. The small bowel is unique among vascularized organ grafts because it not only elicits a vigorous rejection reaction but is also capable of inducing graft-versus-host disease (GVHD). Rejection of the graft does not only lead to loss of function but also to bacterial translocation. The risk of fatal sepsis is aggravated by the immunosuppression given to prevent rejection. Here, the history of SBT is described, and recent developments in experimental and clinical SBT, as well as future prospects for this theoretically optimal treatment modality for patients dependent on total parenteral nutrition (TPN) for life, are outlined.
理论上，小肠移植（SBT）是治疗短肠综合征患者的首选方法。尽管在一些中心，小肠移植已取得了相当程度的成功[36, 145]，但对于短肠综合征患者而言，这绝不是一种既定的或广泛适用的治疗方法。在血管化器官移植中，小肠是独特的，因为它不仅会引发强烈的排斥反应，还能够诱发移植物抗宿主病（GVHD）。移植物的排斥不仅会导致功能丧失，还会导致细菌移位。用于预防排斥的免疫抑制会加重致命性败血症的风险。在此，将描述小肠移植的历史，并概述实验性和临床小肠移植的最新进展，以及这种理论上对依赖全肠外营养（TPN）维持生命的患者而言的最佳治疗方式的未来前景。
