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Stoma or No Stoma in Intestinal Transplantation

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Small-Bowel Transplantation

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Abstract

More effective methods of host and donor organ immunosuppression and improved microvascular techniques have led to increased interest in small-bowel transplantation in various experimental models. Prior to this decade, intestinal graft loss was frequently the result of technical problems of vascular thrombosis or hemorrhage and in some studies approached 40%–50%. Recently, the reported early graft failure from arterial or venous thrombosis has been less than 10% (Dilez-Perez et al. 1984; Pritchard et al. 1985). The use of cyclosporine as an immunosuppressive has resulted in prolonged intestinal allograft survival (Craddock et al. 1983; Dilez- Perez et al. 1984). Although interest in clinical trials is being rekindled by the improvement in experimental results, it is clear that there are still many unanswered questions about the technical aspects of small-bowel transplantation.

Supported in part by NIH grants AM34232 and AM30468.

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References

  • Ahonen A, Nemlander A, Wiktorowitz K, von Willebrand E, Hekali R, Lalla M, Hayry P (1983) Effect of cyclosporine on wound healing. Transplant Proc 15: 3092

    CAS  Google Scholar 

  • Alican F, Hardy JD, Cayiri M, Varner JE, Moynihan PC, Turner MD, Anas P (1971) Intestinal transplantation: Laboratory experience and report of a clinical case. Am J Surg 121: 150

    Article  PubMed  CAS  Google Scholar 

  • Aszodi A, Ponsky L (1984) Effects of corticosteroid on the healing bowel anastomosis. Am Surg 50: 546

    PubMed  CAS  Google Scholar 

  • Atkinson K, Britten K, Pauli P, Farrell C, Concannon A, Dodds A, Biggs J (1983) Detrimental effect of intestinal disease on absorption of orally administered cyclosporine. Transplant Proc 15: 2446

    Google Scholar 

  • Ballinger WF, Christy MG, Ashby WB (1962) Auto-transplantation of the small intestine: The effect of denervation. Surgery 52: 151

    PubMed  Google Scholar 

  • Cassidy S, Verdenheimer MC (1985) Complications of intestinal stomas. Probl Gen Surg 2: 545

    Google Scholar 

  • Cohen WB, Hardy MA, Quint J, State D (1969) Absorptive function in canine jejunal autografts and allografts. Surgery 65: 440

    PubMed  CAS  Google Scholar 

  • Cohen Z, Nordgren SR, Mackenzie RD, Lossing AG, Stiller CR, Langer B (1983) Pharmacokinetics of cyclosporine in a canine intestinal transplantation model. Transplant Proc 15: 3013

    CAS  Google Scholar 

  • Cohen Z, Nordgren SR, Lossing AC, Cullen J, Craddock G, Langer B (1984) Morphologic studies of intestinal allograft rejection. Immunosuppression with cyclosporine. Dis Colon Rectum 27: 228

    Article  PubMed  CAS  Google Scholar 

  • Craddock GN, Nordgren SR, Reznick RK, Gilas T, Lossing AG, Cohen Z, Stiller CR, Cullen JB, Langer B (1983) Small bowel transplantation in the dog using cyclosporine. Transplantation 35: 284

    Article  PubMed  CAS  Google Scholar 

  • Deltz E, Ulrichs K, Engemann R, Schack T, Friedrichs B, Muller-Ruchholtz W, Muller-Hermelink HK, Thiede A (1983) Prevention of graft-versus-host reaction following small bowel transplantation by temporary cyclosporine treatment. Transplant Proc 15: 3027

    CAS  Google Scholar 

  • Dilez-Perez HS, McClure J, Bedetti C, Hong H, DeSantibanes E, Shaw Jr BW, Thiel DV, Iwatsuki S, Starzl TE (1984) Successful small bowel allotransplantation in dogs with cyclosporine and prednisone. Transplantation 37: 126

    Article  Google Scholar 

  • Dummer JS, Hardy A, Poorsattar A, Ho M (1983) Early infections in kidney, heart and liver transplant recipients on cyclosporine. Transplantation 36: 259

    Article  PubMed  CAS  Google Scholar 

  • Ehrlich HP, Hunt TK (1969) The effect of cortisone and anabolic steroids on the tensile strength of healing wounds. Ann Surg 170: 203

    Article  PubMed  CAS  Google Scholar 

  • Fortner JG, Sichuk G, Litwin SD, Beattie EJ (1972) Immunological responses to an intestinal allograft with HL-A identical donor-recipient. Transplantation 14: 531

    Article  PubMed  CAS  Google Scholar 

  • Gallagher ND, Harrison DD, Skyring AP (1962) Fluid and electrolyte imbalances in patients with long-established ileostomies. Gut 3: 219

    Article  PubMed  CAS  Google Scholar 

  • Hardy MA, Quint J, Cohen WB, State D (1968) 14C-D-glucose absorption in heterotopic jejunal allografts. Gastroenterology 54: 1295

    Google Scholar 

  • Hardy MA, Quint J, State D (1970) Effect of anti-lymphocyte serum and other immunosuppressive agents on canine jejunal allografts. Ann Surg 171: 51

    Article  PubMed  CAS  Google Scholar 

  • Holmes JT, Yeh SDJ, Winawer SI, Kawano N, Fortner JG (1970) Absorption studies in canine jejunal allografts. Ann Surg 174: 101

    Article  Google Scholar 

  • Holmes JT, Klein MS, Winawer S J, Fortner JG (1971) Morphological studies of rejection in canine jejunal allografts. Gastroenterology 61: 693

    PubMed  CAS  Google Scholar 

  • Irwin TT (1978) Effects of malnutrion and hyperalimentation on wound healing. Surg Gynecol Obstet 146: 33

    Google Scholar 

  • Jonsson K, Jiborn H, Zederfeldt B (1983) Breaking strength of small intestinal anastomoses. Am J Surg 145: 800

    Article  PubMed  CAS  Google Scholar 

  • King CE, Toskes PP (1979) Small intestine bacterial overgrowth. Gastroenterology 76: 1035

    PubMed  CAS  Google Scholar 

  • Kirkman RL, Lear PA, Madara JL, Tilney NL (1984) Small intestinal transplantation in the rat: Immunology and function. Surgery 96: 280

    PubMed  CAS  Google Scholar 

  • Kort WJ, Westbroek DL, MacDiken I, Lamijer LDF (1973) Orthotopic total small bowel transplantation in the rat. Eur Surg Res 5: 81

    Article  PubMed  CAS  Google Scholar 

  • Kunlin A, Gaston JP, Shiu MH, Winawer SJ, Fortner JG (1971) The isolated allograft pouch: A useful method for monitoring small bowel allografts. Surg Forum 22: 237

    PubMed  CAS  Google Scholar 

  • Lee KKW, Schraut WH (1985) In vitro allograft irradiation prevents graft-versus-host disease in small bowel transplantation. J Surg Res 38: 364

    Article  PubMed  CAS  Google Scholar 

  • Lillehei RC, Idezuki J, Feemster JA, Dietzmann RH, Kelly WD, Merkel FK, Goetz FC, Lyons GW, Manax WG (1967) Transplantation of stomach, intestine and pancreas: Experimental and clinical observations. Surgery 62: 721

    PubMed  CAS  Google Scholar 

  • Lossing A, Nordgren S, Cohen Z, Cullen J, Craddock G, Langer B (1983) Histologic monitoring of rejection in small intestinal transplantation. Transplant Proc 14: 643

    Google Scholar 

  • Mackenzie R, Nordgren S, Lossing A, Craddock G, Cohen Z, Stiller C, Langer B (1982) Cyclosporine A absorption in canine small intestinal transplantation. Transplant Proc 14: 646

    PubMed  CAS  Google Scholar 

  • Madara JL, Kirkman RL (1985) Structure and functional evolution of jejunal allograft rejection in rats and the ameliorating effects of cyclosporine therapy. J Clin Invest 75: 502

    Article  PubMed  CAS  Google Scholar 

  • Mouchick GJ, Rüssel PS (1971) Transplantation of small bowel in the rat: Technical and immunologic considerations. Surgery 70: 693

    Google Scholar 

  • Morowitz DA, Kirsner JB (1981) Ileostomy in ulcerative colitis: A questionnaire study of 1803 patients. Am J Surg 141: 370

    Article  PubMed  CAS  Google Scholar 

  • Nordgren S, Cohen Z, Mackenzie R, Finkelstein D, Greenberg G, Langer B (1984) Functional monitors of rejection in small intestinal transplants. Am J Surg 147: 153

    Article  Google Scholar 

  • Olivier C, Rettori R, Olivier C, Baur O, Roux J (1969) Un cas de transplantation orthotopique de jejuno-iléon et des colons droit et transverse. Presse Med 77: 1275

    PubMed  CAS  Google Scholar 

  • Parker TH, O’Leary JP (1978) Effect of preparation of the small intestine on microflora and postoperative wound infection. Surg Gynecol Obstet 146: 379

    PubMed  CAS  Google Scholar 

  • Pritchard MD, Madara JL, Tapper MD, Kirkman RL (1985) Failure of cyclosporine to prevent small bowel allograft rejection in pigs. J Surg Res 38: 553

    Article  PubMed  CAS  Google Scholar 

  • Raju S, Didlake RH, Cayirli M, Turner MD, Grogan JB, Achard J (1984) Experimental small bowel transplantation utilizing cyclosporine. Transplantation 38: 561

    Article  PubMed  CAS  Google Scholar 

  • Reznick RK, Craddock GN, Langer B, Gilas T, Cullen JB (1982) Structure and function of small bowel allografts in the dog: Immunosuppression with cyclosporine A. Can J Surg 25: 51

    PubMed  CAS  Google Scholar 

  • Ricour C, Revillon Y, Arnaud-Ballandier F, Ghnassia D, Weyne P, Lauffenberger A, Jos J, Fontaine JL, Gallix P, Vaiman M (1983) Successful small bowel allografts in piglets using cyclosporine A. Transplant Proc 15: 3019

    CAS  Google Scholar 

  • Rubin RH, Wolfson JS, Cosimi AB, Tolkoff-Rubin NE (1981) Infection in the renal transplant recipient. Am J Med 70: 405

    Article  PubMed  CAS  Google Scholar 

  • Ruiz JO, Uchida H, Schultz LS, Lillihei RC (1972) Problems in absorption and immunosuppression after entire intestinal allotransplantation. Am J Surg 123: 297

    Article  PubMed  CAS  Google Scholar 

  • Schiller WR, Suriyapa C, Mutchler JHW, Gohara SF, Anderson MC (1973) Motility changes associated with canine intestinal allografting. J Surg Res 15: 379

    Article  PubMed  CAS  Google Scholar 

  • Stanford WP, Hardy MA (1974) Fatty acid absorption in jejunal autograft and allograft. Surgery 75: 495–502

    Google Scholar 

  • Toledo-Pereyra LH, Raij L, Simmons RL, Najarian JS (1974) Role of endotoxin and bacteria in long- term survival of preserved small-bowel allografts. Surgery 73: 474

    Google Scholar 

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Author information

Authors and Affiliations

  1. Irvington House Institute Fellow, USA

    J. Chabot

Authors
  1. G. Tannenbaum
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  2. A. I. Benvenisty
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  3. J. Chabot
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  4. M. A. Hardy
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Editor information

Editors and Affiliations

  1. Abtl. Allgemeine Chirurgie, Christian-Albrechts-Universität Kiel, Arnold-Heller Straße 7, D-2300, Kiel, Germany

    Eberhard Deltz , Arnulf Thiede  & Horst Hamelmann ,  & 

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© 1986 Springer-Verlag Berlin Heidelberg

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Tannenbaum, G., Benvenisty, A.I., Chabot, J., Hardy, M.A. (1986). Stoma or No Stoma in Intestinal Transplantation. In: Deltz, E., Thiede, A., Hamelmann, H. (eds) Small-Bowel Transplantation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-71087-2_36

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  • DOI: https://doi.org/10.1007/978-3-642-71087-2_36

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-71089-6

  • Online ISBN: 978-3-642-71087-2

  • eBook Packages: Springer Book Archive

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