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ECD for Small Intestine Transplantation

  • Takehisa Ueno
Chapter

Abstract

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.

Keywords

Intensive Care Unit Stay Intestinal Transplantation Intestinal Failure Elevated Liver Function Test Intestinal Graft 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Japan 2014

Authors and Affiliations

  1. 1.Pediatric Surgery, Graduate School of MedicineOsaka UniversitySuitaJapan

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