Improved anti-rejection drugs, refined surgical procedures, and a greater understanding of immunology have contributed to successful intestinal transplants. Short-term survival is now comparable to lung transplantation results. International Intestinal Transplant Registry is a comprehensive database of patients who have received intestinal transplantation.
Prograf® (tacrolimus) has been given to most intestinal transplant patients over the past 20 years. The commonest cause of death following intestinal transplantation is from sepsis, multiple organ system failure or rejection. Some patients have died of post transplant lymphoproliferative disease.
Intestinal transplantation has become the standard of care for intestinal failure in patients in whom intestinal rehabilitation has been unsuccessful or is not possible. It has evolved over time resulting in short-term graft survival rates that are similar to the results of other solid organ transplants. Clinicians and scientists are working on strategies to ensure long term graft and patient survival.
Newer methods to diagnose rejections are being introduced in addition to immunologic monitoring utilizing measurement of donor specific antibody titers, anticipating rejection episodes and treating them before a full blown clinical rejection develops. Introduction of better infectious prophylaxis has reduced the incidence of infections as deaths as well.