Small bowel transplantation under oral immunosuppression: experimental study in the pig

Despite recent improvements, clinical intestinal transplantation remains an experimental procedure for the treatment of irreversible failure of the intestine. Depending on the extent of additional failures, the transplant of the bowel can also be performed as a part of a multivisceral graft. Although these procedures have been performed preclinically for many years and have also been reported to have a successful outcome in the clinical setting, they have not yet become routine, unlike the transplant of other organs. With the aim of improving clinical results, many groups are studying on experimental models. Experimental studies are predominantly performed in rats, with fewer studies conducted in large animals. In 1992, the authors began an experimental program of orthotopic liver-small bowel transplantation (OLSBTx) and surgical technique. Results in the pig have been described for the first time by our group. Despite an acceptable control of rejection, results of intestinal function were poor. The OLSBTx is a high-risk procedure, and in animals an aggressive postoperative treatment is impossible. We therefore decided to continue with the transplant of the small bowel alone (SBTx) because it is a less demanding procedure.