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  • Print publication year: 2011
  • Online publication date: September 2011

Chapter 36 - Intestinal transplantation

from Section 6 - Other abdominal organs

Summary

The most common causes of death after the first year following liver transplantation are recurrent and de novo malignancy, return of the original liver disease in the graft, sepsis, cardiovascular disease, and chronic rejection. Review frequency varies between centers and depends partly on patient morbidity. The aim of follow-up is to screen for graft dysfunction and the late complications of liver transplantation. Complications of immune suppression may be related to the original etiology or unrelated and similar to other organs. Azathioprine (AZA) or mycophenolate mofetil (MMF) are often used as long-term maintenance immunosuppression. Up to 45% of liver transplant recipients have metabolic syndrome that includes excessive weight gain, hypertension, diabetes, and hyperlipidemia. Biliary stricture and incisional hernia are the most common late surgical complications after liver transplantation. Psychosocial health should be considered as an important facet in the long-term management of liver transplant recipient.

Further reading

GrantD.Current results of intestinal transplantation. The International Intestinal Transplant Registry. Lancet 1996; 347: 1801–3.
LloydDA, VegaR, BassettP, ForbesA, GabeSM. Survival and dependence on home parenteral nutrition: experience over a 25-year period in a UK referral centre. Aliment Pharmacol Ther 2006; 24: 1231–40.
MiddletonSJ, Nishida S, Tzakis A, et al. Cambridge-Miami score for intestinal transplantation preoperative risk assessment: initial development and validation. Transplant Proc 2010; 42: 19–21.
MiddletonSJ, PollardS, FriendPJ, et al. Adult small intestinal transplantation in England and Wales. Br J Surg 2003; 90: 723–7.
TodoS, ReyesJ, FurukawaH, et al. Outcome analysis of 71 clinical intestinal transplantations. Ann Surg 1995; 222: 270–80.