Outcomes

According to the international intestinal transplantation registry and data from 55 centers around the world published in 1999 the overall patient and graft survival rates is 69% for isolated intestine recipients at 1 year and 66% and 63% for liver/intestine and multivisceral grafts (Grant, 1997).

The constant evolution of the surgical techniques, the better selection and preparation of the intestinal and multivisceral transplantation candidates, the discovery of new potent immunosuppressive medication, and the tendency to follow these patients closely, has resulted in a constantly improving survival rate. It was previously reported from the University of Miami that the 1-year survival rate for isolated intestinal, liver intestinal, and multivisceral transplantations prior to 1998 was 75%, 40%, and 48%, respectively. The reported 1-year patient and graft survival rates for isolated intestinal transplantations after 1998 have been 84% and 72%, respectively (Nishida et al, 2002). It seems that the introduction of alemtuzumab in conjunction with tacrolimus in the absence of corticosteroids improves the survival rate without any further compromise of the immune system or increased risk for infections. It is noteworthy that though the patient and graft survival rates remain the same a significant portion of these patients do not develop acute rejection episodes.

A recently published single-center series offers further encouraging results for isolated intestinal allograft recipients. Reported 1-year and 3-year actuarial patient survival rates were 88% for both. One-year and 3-year actuarial primary graft survival rates were approximately 78% and 71%, respectively (Fishbein et al, 2003).

Infections and rejection still remain the major lethal complications. The majority of the patients are TPN-free and have a remarkable improvement in quality of life.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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