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Once considered to be an experimental treatment for children with irreversible intestinal failure, intestinal transplantation has progressed into a well-established and life-saving procedure. In the last decade major advances in surgical techniques, immunosuppressive medications, infection prevention and treatment, optimum patient selection and timely placement on the transplant waiting list have contributed to significantly improved outcomes. The emphasis in managing these patients is now on long-term survival and quality of life. The aim of this article is to explore the latest innovations in intestinal transplantation.