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13 results on '"Codeluppi M"'

13. [Outcome of isolated small bowel transplantation in adults: experience from a single Italian center].

Author

Di Benedetto F, Lauro A, Masetti M, Cautero N, De Ruvo N, Quintini C, Sassi S, Di Francesco F, Diago Usò T, Romano A, Dazzi A, Molteni G, Begliomini B, Siniscalchi A, De Pietri L, Bagni A, Merighi A, Codeluppi M, Girardis M, Ramacciato G, and Pinna AD

Subjects
Adolescent, Adult, Female, Graft Rejection prevention & control, Humans, Immunosuppressive Agents administration & dosage, Intestinal Diseases surgery, Intestine, Small pathology, Italy, Male, Middle Aged, Retrospective Studies, Survival Analysis, Transplantation, Homologous adverse effects, Treatment Outcome, Intestine, Small transplantation
Abstract

Aim: Isolated small bowel transplantation is becoming the treatment of choice for adult patients with serious parenteral nutrition (PN) related complications: we report our three-year experience (December 2000-December 2003) from a single Italian center (Modena-Italy), with one of the larger European series., Methods: We transplanted 14 patients, with a previous mean PN course of 27 months and a mean 21-month post-transplantation follow-up (range 3-36 months), obtaining a one-year actuarial survival rate of 92.3% with no intraoperative deaths., Results: We lost 1 patient (7.2%), died for post-transplantation overwhelming sepsis following Cytomegalovirus (CMV) enteritis. Thirteen patients are alive, with one-year actuarial graft survival rate of 85.1%: 1 patient underwent graft removal (7.2%) for intractable severe acute rejection. Our immunosuppressive regimen was based on tacrolimus and 3 induction protocols: daclizumab (8 patients) with steroids, alemtuzumab (4 patients) and thymoglobulin (2 patients) without steroids. In 9 cases, we added sirolimus. Nine recipients experienced 22 episodes of acute cellular rejection (ACR), treated successfully in all cases but one. One patient (7.2%) was treated successfully for Post Transplant Lymphoproliferative Disease (PTLD) and is disease-free after 8 months., Conclusions: Small bowel transplantation can achieve optimal results depending on appropriate immunosuppressive management and candidate selection, added to shorter ischemia time and careful donor and graft selection.

Published
2005

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