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Up until March 31, 2005, a total of 1292 intestinal transplants in 1210 patients have been reported at 65 centers to the International Intestinal Registry: 570 were isolated small-bowel transplants, 490 combined liver-small-bowel transplants and 232 were multivis-ceral transplants. Of the 1292, 772 intestinal transplants were performed in 721 pediatric recipients. For transplants carried out between 2003 and 2005, graft survival at 1 year was calculated to be around 80% with a patient survival percentage that was somewhat higher. Center experience, patient status prior to transplantation and induction therapy and the type of calcineurin inhibitor had a significant impact on outcome. Sepsis was the leading cause of death. Most survivors have full graft function with no requirement for parenteral nutrition (Figs. 1-4; Table 1) [1].

We have performed altogether 4 small bowel transplants in three patients suffering from end stage Crohn's disease. Patient characteristics are summarized in Table 1.

Patient #1 was a 35-year-old male who had a completely uneventful postoperative course and is alive and well with good graft function 64 months after transplantation.

Patient #2 was a 37-year-old female who lost the first graft 2 years after transplantation for chronic rejection and underwent re-transplantation in June

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Fig. 1. 2003-2005 patient survival according to transplant type. MVT, multivisceral transplantation; SB/Liver combined small bowel-liver transplantation; SBT, small bowel transplantation alone m I

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Graft survival (years)

2002. 42 months later she has a well function bowel allograft, but requires intermittent hemodialysis for chronic renal failure.

Patient #3 was a 60-year-old female suffering from endstage intestinal and renal failure due to chronic pyelonephritis und underwent combined small bowel-kidney transplantation on July 7, 2003. She developed early after transplantation a T-cell lymphoma of the intestinal graft requiring resection of the graft. 29 months later she is alive with good renal allograft function.

Fig. 3. Graft survival according to pretransplantation status of the recipients. Home, patients awaiting transplantations at home; hospitalized, patients awaiting transplantation at the hospital

Fig. 2. 2003-2005 graft survival according to D-transplant type. MVT, multivisceral transplantation; SB/Liver, combined small bowel-liver transplantation; SBT, small bowel transplantation alone

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