Clinical intestinal transplantation: focus on complications.

NINE intestinal transplants (three adults. six childrenl have been performed at the University of Pittsburgh since the advent of FK 506. Eight patients had a combined liver-intestinal transplant. one had a solitary intestinal graft. Four of these were performed 3 to 5 weeks before this report. the other five are presented with 5to 16-month follow-ups. The clinical profiles of the patients at transplantation are presented in Table I. Eight patients are alive with the original grafts including the pattent with the solitary mtestinal graft. One patient died. The methods and techniques have been previously reported. 1-4 Briefly. the solitary intestinal transplant was arterialized from the infrarenal aorta and drained into the recipient superior mesenteric vein. In the case of the liver-intestinal combination. seven were placed piggybackS onto the recipient inferior vena cava (lYC) and. in one case. the retrohepatlc IYC was replaced by the respective donor cava. Arterialization was from the infrarenal aorta with the use of fresh vascular grafts. A portacaval shunt provided permanent drainage of the recipient portal vein (PV) in two cases. In the remaining cases. the PY of the recipient was drained into the PY of the donor. A temporary portacaval shunt during the pro-