イタリアにおける成人小腸単独移植：２８例２９移植の経験から

DOI Web Site 参考文献21件
  • 木村 拓也
    S'Orsola-Malpighi Hospital, University of Bologna, Liver and Multiorgan Transplant Unit.
  • Lauro Augusto
    S'Orsola-Malpighi Hospital, University of Bologna, Liver and Multiorgan Transplant Unit.
  • Cescon Matteo
    S'Orsola-Malpighi Hospital, University of Bologna, Liver and Multiorgan Transplant Unit.
  • Zanfi Chiara
    S'Orsola-Malpighi Hospital, University of Bologna, Liver and Multiorgan Transplant Unit.
  • Pinna Antonio Daniele
    S'Orsola-Malpighi Hospital, University of Bologna, Liver and Multiorgan Transplant Unit.
  • 福澤 正洋
    大阪大学大学院外科学講座小児外科学

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  • Clinical Experience of Isolated Intestinal Transplantation in Adult: A Report of 29 Consecutive Series

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Introduction: We review our work in adult intestinal transplantation at a European single center. Patients and Methods: In the last 7 years, we have conducted 29 isolated intestinal transplants in 28 adults whose underlying diseases were short bowel syndrome (17), intestinal failure (9), and intestinal tumors (2). Transplant indications were loss of venous access (15), recurrent sepsis (12) and electrolyte fluid imbalance (5). Immunosuppression was based on monoclonal antibodies using induction therapy. In the early period, daclizumab was used for induction, and tacrolimus and steroids were administered for maintenance. After 2002, we applied alemtuzumab or antithymocyte globulin as an induction agent with low-dose tacrolimus monotherapy maintenance. Results: Median follow-up was 977 days. Actuarial 5-year patient survival was 74% and graft survival 71%. Death was caused by sepsis and graftectomy mainly by rejection unresponsive to anti-rejection therapy. Among the 22 recipients alive, 19 (86%) have normal bowel function with a regular diet without parenteral support. Conclusions: Isolated intestinal transplantation in adults had 5-year patient and graft survival rates similar to those in other solid organ transplantation. Intestinal transplantation thus appears to be an effective alternative in patients with intestinal failure and/or short bowel syndrome; however, further study is needed to establish as standard treatment.

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