Asfar S, Atkison P, Ghent C, Duff J, Wall W, Williams S, Seidman E, Grant D
Multi-Organ Transplant Service, University Hospital, London, Ontario, Canada.
Dig Dis Sci. 1996 May;41(5):875-83. doi: 10.1007/BF02091526.
Thirty-seven patients were listed for small bowel transplantation; 16 were transplanted and 15 died while waiting for a donor. Cyclosporine (N = 6) or tacrolimus (N = 10) were used for immune suppression. Graft rejection rates were lower in the combined liver/small bowel grafts than the isolated intestinal transplants (1/7 vs 5/7; P < 0.01) All of the cyclosporine group have died; the median survival was 25.7 months with two patients living more than five years. The tacrolimus group had fewer infections and a shorter hospital stay. All but two are alive with a median survival of 13 months. Seven of eight long-term survivors are off intravenous feedings. We conclude that small bowel transplantation is a life-saving option for patients with intestinal failure who cannot be maintained on total parenteral nutrition.
37名患者被列入小肠移植名单；16人接受了移植，15人在等待供体期间死亡。使用环孢素（n = 6）或他克莫司（n = 10）进行免疫抑制。肝/小肠联合移植的移植物排斥率低于单纯小肠移植（1/7对5/7；P < 0.01）。环孢素组的所有患者均已死亡；中位生存期为25.7个月，有两名患者存活超过五年。他克莫司组感染较少，住院时间较短。除两名患者外，其余患者均存活，中位生存期为13个月。八名长期存活者中有七名不再需要静脉喂养。我们得出结论，小肠移植对于无法通过全肠外营养维持的肠衰竭患者是一种挽救生命的选择。
