Copyright ©2012 Baishideng. All rights reserved.
World J Transplant. Dec 24, 2012; 2(6): 95-103
Published online Dec 24, 2012. doi: 10.5500/wjt.v2.i6.95
Where are we at with short bowel syndrome and small bowel transplant
Baris Dogu Yildiz
Baris Dogu Yildiz, Transplantation Surgery, Ankara Numune Teaching and Research Hospital, Ankara 06100, Turkey
Author contributions: Yildiz BD solely contributed to this paper.
Correspondence to: Baris Dogu Yildiz, MD, Head of Transplantation Surgery, Ankara Numune Teaching and Research Hospital, Ankara 06100, Turkey.
Telephone: +90-532-4454655 Fax: +90-312-4241520
Received: September 2, 2011
Revised: June 26, 2012
Accepted: October 31, 2012
Published online: December 24, 2012

Intestinal failure can be defined as the critical reduction of functional gut mass below the minimal amount necessary for adequate digestion and absorption to satisfy body nutrient and fluid requirements in adults or children. Short bowel syndrome (SBS) is characterized by a state of malabsorption following extensive resection of the small bowel. SBS may occur after resection of more than 50% and is certain after resection of more than 70% of the small intestine, or if less than 100 cm of small bowel is left. Several treatment modalities other than total parenteral nutrition, including hormones (recombinant human growth hormone, glucagon-like peptide-2) and tailoring surgeries (Bianchi procedure, serial transverse enteroplasty), had been proposed, however these were either experimental or inefficient. Small bowel transplant is a rather new approach for SBS. The once feared field of solid organ transplantation is nowadays becoming more and more popular, even in developing countries. This is partially secondary to the developments in immunosuppressive strategy. In this regard, alemtuzumab deserves special attention. There are more complex surgeries, such as multivisceral transplantation, for multi-organ involvement including small bowel. This latter technique is relatively new when compared to small bowel transplant, and is performed in certain centers worldwide. In this review, an attempt is made to give an insight into small bowel syndrome, small bowel transplantation, and related issues.

Keywords: Short bowel syndrome, Small bowel transplantation, Nutrition, Immunosuppression