Short bowel syndrome and small bowel transplantation

John K. DiBaise

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

PURPOSE OF REVIEW: The purpose of this review is to provide an update of recent advances in the areas of short bowel syndrome (SBS) and small bowel transplantation (SBT). RECENT FINDINGS: Recent reports from two of the largest multicenter randomized, controlled trials in patients with SBS support the safety and efficacy of teduglutide as an aid to parenteral nutrition weaning. In well selected SBS patients, outcomes as diverse as survival, macronutrient absorption and parenteral nutrition weaning are improved after autologous gastrointestinal reconstructive surgery. SBT is no longer considered investigational and given improved outcomes noted in recent reports, indications for transplantation are expanding. Although SBT early survival rates are approaching those of other organ allografts, long-term graft survival remains suboptimal. SUMMARY: Recently available trophic factors hold promise as aids in restoring freedom from parenteral nutrition support; however, their long-term benefits, preferred timing of administration in relation to the onset of SBS, optimal patient selection for use, duration of treatment and cost effectiveness require further study. Despite recent evidence of improved early survival after SBT, more dedicated research is needed to design more effective strategies to better tolerize small bowel grafts, prevent rejection and, ultimately, improve long-term outcomes. Reserved for well selected patients, autologous gastrointestinal reconstruction should be considered complementary and not antagonistic to SBT.

Original languageEnglish (US)
Pages (from-to)128-133
Number of pages6
JournalCurrent Opinion in Gastroenterology
Volume30
Issue number2
DOIs
StatePublished - Mar 1 2014

Keywords

  • Autologous gastrointestinal reconstruction
  • Intestinal adaptation
  • Short bowel syndrome
  • Small bowel transplantation
  • Trophic factor

ASJC Scopus subject areas

  • Gastroenterology

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