Patient and methods: Between December 2004 and December 2012 we have evaluated 58 patients most of them not eligible and have performed 21 intestinal transplants in 19 patients. Seventeen were intestinal (IT) and 4 multivisceral (MVT).

Results: Short bowel syndrome was found in 63 % (12/19) of the patients. Seventy nine percent were under HPN (15/19 patients) and 93 % of them (13/14 patients) had complications HPN related. Main cause for transplant was irresectable desmoid tumor (37%), follow by vascular thrombosis (21%) and others. Mean time for transplant was 137 days. Infectious diseases were the most common complication (51% of all medical complications) from central line infection and related with the surgical mesh for temporary closure of the wound in most cases. Renal failure was also frequent (14%; 13/19 patients) due to multiple causes. Surgical complications were frequent, but most of them (>50%) mild and related to the surgical mesh, but leading to a great number of reoperations and prolonged in hospital stay. We have explanted 5/21 grafts (23%) mainly due to severe graft rejection (3 patients), but rate of graft loss was 7/21 (33%) because of two patients died with normal graft function. Acute rejection (AR) was very frequent with a rate around 52% (11/21 grafts). Most of these episodes of AR (>71%) were mild and just 27% moderate to severe (33% of these refractory to conventional treatment). Finally we have had an 11% of PTLD in our patients. Mean follow up for patients and grafts was 32 and 28 months respectively. Overall survival was 63% (12/19). Actuarial survival for patients at one, 3, 5 and 7 years was: 83,6%; 63,6%; 54,5% and 54,5% respectively. Actuarial survival for grafts at one, 3, 5 and 7 years was: 68,8%; 62%; 53% and 53% respectively.

Conclusions: In spite of complications, short and little experience, our results are not that bad similar to other high volume and experienced centers around the world and also similar to that achieved by TPN; although carefully patients selection must be done.