Salvage Procedures for Technical Complications After Intestinal Transplantation

Abstract

In comparison to other types of organ transplants in children, intestinal transplantation remains a relatively rare procedure. In addition, the heterogeneous varieties of composite allografts containing an intestine and the varied ways of performing the vascular anastomoses make any individual intestinal transplant far more distinct when compared to other abdominal transplant procedures. Although this can make the presentation and diagnosis of any given complication more difficult, certain anatomic themes remain and will be discussed in this chapter. Vascular complications, though thankfully infrequent in this population, remain a constant threat and threaten both allograft and patient survival. This chapter focuses on the rapid diagnosis and management of technical issues that contribute dramatically to the morbidity and often mortality, associated with intestinal transplant. As these complications are fortunately rare, there is little to no literature to reference with the most complete series representing a sum total of 38 major surgical complications. To offset this, we have supplied an in-depth analysis of individual cases, and references were supplied where possible to offer other potential solutions to these infrequent clinical conundrums.