Isolated intestinal transplantation may be performed with portal or systemic drainage. If the venous outflow is drained into the portal system via the superior mesenteric vein or directly into the portal vein, the transplant is called orthotopic. If, for technical reasons, portal drainage cannot be achieved, the superior mesenteric vein of the graft is anastomosed to the inferior vena cava; therefore, this type of transplant called heterotopic.
The graft artery is virtually in all cases anastomosed to the infrarenal aorta. In case of a segmental jejunoileum graft from a live donor, recipient iliac vessels are preferentially used for revascularization. The proximal end of the gut is attached to the first loop of native jejunum or to the third portion of duodenum. Isolated bowel transplant is carried out in patients with intestinal failure but no damage to the liver or other organs.
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