Monitoring and treatment of intestinal allograft rejection in humans.

Abstract

Over a period of 25 months, 23 small bowel transplants have been performed at the University of Pittsburgh since the advent of FK 506. Twelve patients were adults and 11 were children. Nine patients received an intestine alone, 12 received an intestine in continuity with the liver, and two received a full multivisceral graft. The donors were all ABO identical and HLA histoincompatible. The lymphocytotoxic crossmatch was positive in two cases. No attempts were made to alter the graft lymphoreticular tissue with antilymphocyte preparations or other modalities. One of the isolated small bowel recipients required retranspiantation after 22.5 months because of chronic rejection. Nineteen of the 23 patients are currently alive with a median follow-up of 231 days (range 67 to 754). The surgical techniques, details of patient and graft survival, as well as quality of graft function are fully described elsewhere in this issue.1,2