The prognosis of intestinal failure has improved dramatically owing to the development of parenteral nutrition. However, parenteral nutrition-related complications, such as central venous catheter infection, venous access thrombosis, and intestinal failure associated with liver disorder, are still major causes of mortality in patients with intestinal failure. Intestinal transplantation can significantly improve their prognosis and quality of life. Intestinal transplantation has become an established treatment for intestinal failure, with more than 2,300 intestinal transplants performed worldwide.
However, an accepted definition of marginal intestinal donor has not been definitively established. Among the most prominent donor characteristics that may influence graft survival include older age, cardiopulmonary arrest, viral status, graft size mismatch, and elevated liver function tests (LFTs). More long-term determinants of poor patient and graft survival are crossmatch positivity and donor-specific antigen positivity.
According to current donor criteria for intestinal transplantation, extended criteria for donation of intestinal transplant grafts include donor age 50–60 years, CPR longer than 10 min, ABO compatibility, ICU stay from 1 week up to 2 weeks, high doses of vasopressors, elevated LFTs, sodium level 150–160 mEq/L, and a compatible donor–recipient size match. Any extended criteria donor graft should be considered potentially suitable for the patients on long waiting lists and not be discarded without seeking timely intestinal transplantation.
Intensive Care Unit Stay Intestinal Transplantation Intestinal Failure Elevated Liver Function Test Intestinal Graft
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Mangus RS, Fridell JA, Vianna RM, et al. Comparison of histidine-tryptophan-ketoglutarate solution and University of Wisconsin solution in extended criteria liver donors. Liver Transpl. 2008;14(3):365–73.PubMedCrossRefGoogle Scholar
Mazariegos GV, Steffick DE, Horslen S, et al. Intestine transplantation in the United States, 1999–2008. Am J Transplant. 2010;10(4 Pt 2):1020–34.PubMedCrossRefGoogle Scholar
Yersiz H, Renz JF, Hisatake GM, et al. Multivisceral and isolated intestinal procurement techniques. Liver Transpl. 2003;9(8):881–6.PubMedCrossRefGoogle Scholar
Furukawa H. Establishment of educational program for multi-organ procurement from deceased donors. Ministry of Health and Laber Welfare, Japan. 2013.Google Scholar
Barr ML, Belghiti J, Villamil FG, et al. A report of the Vancouver Forum on the care of the live organ donor: lung, liver, pancreas, and intestine data and medical guidelines. Transplantation. 2006;81(10):1373–85.PubMedCrossRefGoogle Scholar
Pascher A, Kohler S, Neuhaus P, et al. Present status and future perspectives of intestinal transplantation. Transpl Int. 2008;21(5):401–14.PubMedCrossRefGoogle Scholar
Gondolesi G, Fauda M. Technical refinements in small bowel transplantation. Curr Opin Organ Transplant. 2008;13(3):259–65.PubMedCrossRefGoogle Scholar
Tzakis AG, Kato T, Levi DM, et al. 100 multivisceral transplants at a single center. Ann Surg. 2005;242(4):480–90. discussion 491–3.PubMedCentralPubMedGoogle Scholar
Abu-Elmagd K, Fung J, Bueno J, et al. Logistics and technique for procurement of intestinal, pancreatic, and hepatic grafts from the same donor. Ann Surg. 2000;232(5):680–7.PubMedCentralPubMedCrossRefGoogle Scholar
Benedetti E, Holterman M, Asolati M, et al. Living related segmental bowel transplantation: from experimental to standardized procedure. Ann Surg. 2006;244(5):694–9.PubMedCentralPubMedCrossRefGoogle Scholar
de Ville de Goyet J, Mitchell A, Mayer AD, et al. En block combined reduced-liver and small bowel transplants: from large donors to small children. Transplantation. 2000;69(4):555–9.PubMedCrossRefGoogle Scholar
Fischer-Frohlich CL, Konigsrainer A, Schaffer R, et al. Organ donation: when should we consider intestinal donation. Transpl Int. 2012;25(12):1229–40.PubMedCrossRefGoogle Scholar
Matsumoto CS, Kaufman SS, Girlanda R, et al. Utilization of donors who have suffered cardiopulmonary arrest and resuscitation in intestinal transplantation. Transplantation. 2008;86(7):941–6.PubMedCrossRefGoogle Scholar
Keitel E, Michelon T, dos Santos AF, et al. Renal transplants using expanded cadaver donor criteria. Ann Transplant. 2004;9(2):23–4.PubMedGoogle Scholar
Abu-Elmagd K, Reyes J, Bond G, et al. Clinical intestinal transplantation: a decade of experience at a single center. Ann Surg. 2001;234(3):404–16. discussion 416–7.PubMedCentralPubMedCrossRefGoogle Scholar
Zaroff JG, Rosengard BR, Armstrong WF, et al. Consensus conference report: maximizing use of organs recovered from the cadaver donor: cardiac recommendations, March 28–29, 2001, Crystal City, VA. Circulation. 2002;106(7):836–41.PubMedCrossRefGoogle Scholar
Rushton SN, Hudson AJ, Collett D, et al. Strategies for expanding the UK pool of potential intestinal transplant donors. Transplantation. 2013;95(1):234–9.PubMedCrossRefGoogle Scholar
Ruiz P, Carreno M, Weppler D, et al. Immediate antibody-mediated (hyperacute) rejection in small-bowel transplantation and relationship to cross-match status and donor-specific C4d-binding antibodies: case report. Transplant Proc. 2010;42(1):95–9.PubMedCrossRefGoogle Scholar
Wei L, Hata K, Doorschodt BM, et al. Experimental small bowel preservation using Polysol: a new alternative to University of Wisconsin solution, Celsior and histidine-tryptophan-ketoglutarate solution? World J Gastroenterol. 2007;13(27):3684–91.PubMedGoogle Scholar
Olson DW, Fujimoto Y, Madsen KL, et al. Potentiating the benefit of vascular-supplied glutamine during small bowel storage: importance of buffering agent. Transplantation. 2002;73(2):178–85.PubMedCrossRefGoogle Scholar
Leuvenink HG, van Dijk A, Freund RL, et al. Luminal preservation of rat small intestine with University of Wisconsin or Celsior solution. Transplant Proc. 2005;37(1):445–7.PubMedCrossRefGoogle Scholar
Oltean M, Joshi M, Bjorkman E, et al. Intraluminal polyethylene glycol stabilizes tight junctions and improves intestinal preservation in the rat. Am J Transplant. 2012;12(8):2044–51.PubMedCrossRefGoogle Scholar
Zhu JZ, Castillo EG, Salehi P, et al. A novel technique of hypothermic luminal perfusion for small bowel preservation. Transplantation. 2003;76(1):71–6.PubMedCrossRefGoogle Scholar
Tsujimura T, Salehi P, Walker J, et al. Ameliorating small bowel injury using a cavitary two-layer preservation method with perfluorocarbon and a nutrient-rich solution. Am J Transplant. 2004;4(9):1421–8.PubMedCrossRefGoogle Scholar