The fi rst successful small bowel transplantation in the Sklifosovsky Institute for Emergency Medicine
Abstract
The paper describes the first case of successful small bowel transplantation in the Sklifosovsky Research Institute for Emergency Medicine. It contains a brief review of literature on essential aspects of small bowel transplantation, presents the donor’s case history, specific features of anesthesia, surgical procedure, and postoperative course, including the immunosuppression scheme, diagnosis and treatment of evolved complications. The paper provides in-detail results of morphological control over rejection development, presents the data of ultrasonographic observation of the changes in the transplanted intestine in the course of its adaptation to new requirements, covers the tactics of parenteral and enteral nutrition.
About the Authors
M. Sh. KhubutiaRussian Federation
P. A. Yartsev
Russian Federation
V. A. Gulyaev
Russian Federation
A. V. Grishin
Russian Federation
S. A. Tarasov
Russian Federation
N. N. Sheptak
Russian Federation
M. N. Drayer
Russian Federation
V. D. Levitsky
Russian Federation
I. A. Aleksandrova
Russian Federation
V. V. Kiselev
Russian Federation
V. A. Leliuk
Russian Federation
E. B. Riabov
Russian Federation
G. A. Berdnikov
Russian Federation
A. A. Ryk
Russian Federation
A. V. Vodiasov
Russian Federation
O. N. Rzhevskaya
Russian Federation
N. V. Borovkova
Russian Federation
V. Kh. Timerbaev
Russian Federation
E. A. Korotkova
Russian Federation
E. Yu Trofimova
Russian Federation
N. V. Shavrina,
Russian Federation
I. E. Selina
Russian Federation
O. Kh. Kaloyeva
Russian Federation
A. M. Godkov
Russian Federation
G. V. Bulava
Russian Federation
E. V. Klychnikova
Russian Federation
N. V. Evdokimova
Russian Federation
E. B. Lazareva
Russian Federation
I. E. Galankina
Russian Federation
G. P. Titova
Russian Federation
References
1. Carrel, A. The transplantation of organs. A preliminary communication / А. Carrel // J. Am. Med. Assoc. – 1905. – Vol. 45. – P. 1645.
2. Lillehei, R. The physiological response of the small bowel of the dog to ischemia including pro-longed in vitro preservation of the bowel with successful replacement and survival / R. Lillehei, B. Goott, F. Miller // Ann. Surg. –1959. – Vol. 150, N 4.– P. 543–559.
3. Transplantation of stomach, intestine, and pancreas: experimental and clinical observation / R.C. Lillehei, Y. Idezuki, J.A. Feemster [et al.] // Surgery. – 1967. – Vol. 62. – P. 721–741.
4. Pritchard, T.J. Small bowel transplantation / T.J. Pritchard, R.L. Kirkman // World J. Surg. – 1985. – Vol. 9. – P. 860–867.
5. Fishbein, T.M. Intestinal Transplantation / T.M. Fishbein // N. Engl. J. Med.– 2009. – Vol. 361, N 10. – P. 998–1008.
6. Stuart, F.P. Organ Transplantation / F.P. Stuart, M.M. Abecassis,D.B. Kaufman. – 2nd ed. – New York: Landes Bioscience, 2003. – 618 p.
7. Howard, L. Current use and clinical outcome of home parenteral and enteral nutrition therapies in the United States / L. Howard, M. Ament, C.R. Fleming [et al.] // Gastroenterology. – 1995. – Vol. 109, N 2. – P. 355–365.
8. Long-term survival and parenteral nutrition dependence in adult patients with the short bowel syndrome / B. Messing, P. Crenn, P. Beau // Gastroenterology.– 1999.– Vol. 117, N 5.– P. 1043–1050.
9. Survival of home parenteral nutritiontreated patients: 20 years of experience at the Mayo Clinic / J.S. Scolapio, C.R. Fleming, D.G. Kelly // Mayo Clin. Proc. – 1999. – Vol. 74, N 3. – P. 217–222.
10. Howard, L. Current statusof home parenteral nutrition in the United States / L. Howard, M. Malone // Transplant. Proc. – 1996. – Vol. 28, N 5. – P. 2691–2695.
11. Abdominal Multiviscereal Transplantation / S. Todo, A. Tzakis, K. Abu-Elmagd [et al.] // Transplantation. – 1995. – Vol. 59, N 2. – P. 234–240.
12. Bacterial translocation is enhanced in pig intestinal transplantation when the colon is included in the graft / M. Spada, M. Alessiani, M. Fabbi [et al.] // Transplant. Proc. – 1996. – Vol. 28, N 5. – P. 2658–2659.
13. Mycophenolate mofetil as primary and rescue therapy in intestinal transplantation / A. Tzakis, D. Weppler, M. Khan [et al.] // Transplant Proc. – 1998. – Vol. 30, N 6. – P. 2677–2679.
14. 51Cr-EDTA: a marker of early intestinal rejection in the rat / D. Grant,D. Lamont, R. Zhong [et al.] // J. Surg. Res. – 1989. – Vol. 46, N 5. – P. 507–514.
15. Diagnosis of intestinal transplant rejection using 99mtechnetium-DTPA / A.M. D’Alessandro, M. Kalayoglu, R. Hammes [et al.] // Transplantation. – 1994. – Vol. 58, N 1. – P. 112–113.
16. Infectious complications after small bowel transplantation in adults: and update / S. Kusne, H. Furukawa, K. Abu- Elmagd [et al.] // Transplant. Proc. –1996. – Vol. 28, N 5. – P. 2761–2762.
17. Farmer, R.G. Long-term followup of patients with Crohn’s disease / R.G. Farmer, G. Whelan, V.W. Fazio // Gastroenterology. – 1985. – Vol. 88, N 6. –P. 1818–1825.
18. Successful treatment for homozygous protein C deficiency by hepatic transplantation / J.F. Ca-sella, J.H. Lewis, F.A. Bontemps [et al.] // Lancet. – 1988. – Vol. 1, N 8553. – P. 435–438.
19. Intestinal and multiple organ transplantation / J. Reyes, R. Selby, K. Abu-Elmagd [et al.] // Textbook of Critical Care. – 4th ed. – Orlando: WB Saunders Company, 2000. – P. 1986– 1997.
20. Winter HS. Intestinal polyps // Pediatric Gastrointestinal Disease: Pathophysiology, Diagnosis, Managemen / eds. W.A. Walker, P.R. Durie, J.R. Hamilton [et al.]. – 2nd ed. – BC Decker, 1996. – P. 891–906.
21. A case of beriberi accompanying short bowel / K. Hiroi, Y. Goto, J. Ishikawa [et al.] // Acta Paediat. Jpn. – 1995. – Vol. 37, N 1. – P. 84–87.
22. Hove, H. Colonic lactate metabolism and D-lactic acidosis / H. Hove, P.B. Mortensen // Dig. Dis. Sci. – 1995. – Vol. 40, N 2. – P. 320–330.
23. Malposition of a implantable venous access catheter in the azygos vein: report of a case / S. Ikeda, Y. Sera, H. Yamamoto // Surg. Today. – 1995. – Vol. 25, N 7. – P. 649–650.
24. Jenkins, R.C. Growth hormone therapy for protein catabolism / R.C. Jenkins, R.J. Ross // QJM. – 1996. – Vol. 89, N 11. – P. 813–819.
25. Small bowel and liver/small bowel transplantation in children / J. Reyes,A.G. Tzakis, S. Todo // Semin. Pediatr. Surg. – 1993. – Vol. 2, N 4. – P. 289–300.
26. Current status of intestine transplantation in children / J. Reyes, J. Bueno, S. Kocochis [et al.] // J. Pediatr. Surg. – 1998. – Vol. 33, N 2. – P. 243–254.
27. The many faces of multivisceral transplantation / T.E. Starzl, S. Todo,A. Tzakis [et al.] // Surg. Gynecol. Obstet. – 1991. – Vol. 172, N 5. – P. 335–344.
28. Technical aspects of intestine transplantation / H. Furukawa, K. AbuElmagd, J. Reyes [et al.] // Surgical Technology International / eds. M.H. Braverman, R.L. Tawes. – Vol. 3. – San Francisco: University Medical Press,1994. – P. 165–170.
29. Clinical intestine transplantation new perspectives and immunologic considerations / K.M. Abu-Elmagd, J. Reyes, S. Todo [et al.] // J. Am. Coll.Surg. – 1998. – Vol. 186, N 5. – P. 512–527.
30. Current status of intestinal transplantation in children / J. Reyes, J. Bueno, S. Kocoshis [et al.] // J. Pediatr. Surg. – 1998. – Vol. 33, N 2. – P. 243–254.
31. Infectious complications after small bowel transplantation in adults / S. Kusne, R. Manez, H. Bonet [et al.] // Transplant. Proc. – 1994. – Vol. 26, N 3. – P. 1682–1683.
32. Three years clinical experience with intestinal transplantation / K. AbuElmagd, S. Todo, A. Tzakis [et al.] // J. Am. Coll. Surg. – 1994. – Vol. 179, N 4. – P. 385– 400.
33. Wells, C.L. Colonization and translocation of intestinal bacterial flora / C.L. Wells // Transplant. Proc. – 1996. – Vol. 28, N 5. – P. 2653–2656.
34. Infectious complications after small bowel transplantation in adults: an update / S. Kusne, H. Furukawa, K. Abu-Elmagd [et al.] // Transplant. Proc. – 1996. – Vol. б28, N 5. – P. 2761–2762.
35. Berg, R.D. Promotion of the translocation of enteric bacteria from the gastrointestinal tract of mice by oral treatment with penicillin, clindamicyn or metronidazole / R.D. Berg // Infect. Immun. – 1981. – Vol. 33, N 3. – P. 854–861.
Review
For citations:
Khubutia M.Sh., Yartsev P.A., Gulyaev V.A., Grishin A.V., Tarasov S.A., Sheptak N.N., Drayer M.N., Levitsky V.D., Aleksandrova I.A., Kiselev V.V., Leliuk V.A., Riabov E.B., Berdnikov G.A., Ryk A.A., Vodiasov A.V., Rzhevskaya O.N., Borovkova N.V., Timerbaev V.Kh., Korotkova E.A., Trofimova E.Yu., Shavrina, N.V., Selina I.E., Kaloyeva O.Kh., Godkov A.M., Bulava G.V., Klychnikova E.V., Evdokimova N.V., Lazareva E.B., Galankina I.E., Titova G.P. The fi rst successful small bowel transplantation in the Sklifosovsky Institute for Emergency Medicine. Transplantologiya. The Russian Journal of Transplantation. 2013;(3):16-27. (In Russ.)