{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:19:50Z","timestamp":1787023190275,"version":"build-2736575974"},"reference-count":29,"publisher":"FapUNIFESP (SciELO)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Einstein (S\u00e3o Paulo)"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:p>Intestinal transplantation has shown exceptional growth over the past 10 years. At the end of the 1990\u2019s, intestinal transplantation moved out of the experimental realm to become a routine practice in treating patients with severe complications related to total parenteral nutrition and intestinal failure. In the last years, several centers reported an increasing improvement in survival outcomes (about 80%), during the first 12 months after surgery, but long-term survival is still a challenge. Several advances led to clinical application of transplants. Immunosuppression involved in intestinal and multivisceral transplantation was the biggest gain for this procedure in the past decade due to tacrolimus, and new inducing drugs, mono- and polyclonal anti-lymphocyte antibodies. Despite the advancement of rigid immunosuppression protocols, rejection is still very frequent in the first 12 months, and can result in long-term graft loss. The future of intestinal transplantation and multivisceral transplantation appears promising. The major challenge is early recognition of acute rejection in order to prevent graft loss, opportunistic infections associated to complications, post-transplant lymphoproliferative disease and graft versus host disease; and consequently, improve results in the long run.<\/jats:p>","DOI":"10.1590\/s1679-45082015rw3155","type":"journal-article","created":{"date-parts":[[2015,5,8]],"date-time":"2015-05-08T16:49:06Z","timestamp":1431103746000},"page":"136-141","source":"Crossref","is-referenced-by-count":10,"title":["Intestinal and multivisceral transplantation"],"prefix":"10.1590","volume":"13","author":[{"given":"S\u00e9rgio Paiva","family":"Meira Filho","sequence":"first","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca Della","family":"Guardia","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9ia Silva","family":"Evangelista","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celso Eduardo Louren\u00e7o","family":"Matielo","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas Bastos","family":"Neves","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando Luis","family":"Pandullo","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme Eduardo Gon\u00e7alves","family":"Felga","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jefferson Andr\u00e9 da Silva","family":"Alves","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian Amorim","family":"Curvelo","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Gustavo Guedes","family":"Diaz","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela Balbo","family":"Rusi","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo de Melo","family":"Viveiros","sequence":"additional","affiliation":[{"name":"Hospital Santa Marcelina, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcio Dias de","family":"Almeida","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina Gabrielle","family":"Epstein","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamella Tung","family":"Pedroso","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Salvalaggio","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto Ferreira","family":"Meirelles J\u00fanior","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo Andrey","family":"Rocco","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira Scalso de","family":"Almeida","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Bruno de","family":"Rezende","sequence":"additional","affiliation":[{"name":"Hospital Santa Marcelina, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.yasu.2008.03.008","article-title":"Current status of small bowel and multivisceral transplantation","volume":"42","author":"Vianna RM","year":"2008","journal-title":"Adv Surg"},{"issue":"4","key":"ref2","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1097\/SLA.0b013e3181b67725","article-title":"Five hundred intestinal and multivisceral transplantations at a single center: major advances with new challenges","volume":"250","author":"Abu-Elmagd KM","year":"2009","journal-title":"Ann Surg"},{"issue":"2","key":"ref3","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1590\/S0004-28032003000200011","article-title":"Small intestine transplantation","volume":"40","author":"Galv\u00e3o FH","year":"2003","journal-title":"Arq Gastroenterol"},{"key":"ref4","series-title":"Nutri\u00e7\u00e3o oral, enteral e parenteral na pr\u00e1tica cl\u00ednica","first-page":"1539","volume-title":"Transplante de intestino e multivisceral","author":"Galv\u00e3o FH","year":"2008"},{"issue":"1","key":"ref5","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1590\/S0004-28032002000100008","article-title":"Study of morbidity in orthotopic small intestine transplantation with Wistar rats. Experimental study","volume":"39","author":"Lee AD","year":"2002","journal-title":"Arq Gastroenterol"},{"issue":"3","key":"ref6","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1097\/MCO.0b013e32832a2215","article-title":"Present prospects and future perspectives of intestinal and multivisceral transplantation","volume":"12","author":"Vianna RM","year":"2009","journal-title":"Curr Opin Clin Nutr Metab Care"},{"issue":"9","key":"ref7","doi-asserted-by":"crossref","first-page":"1976","DOI":"10.1111\/ajt.12812","article-title":"The current state of intestine transplantation: indications, techniques, outcomes and challenges","volume":"14","author":"Sudan D","year":"2014","journal-title":"Am J Transplant"},{"issue":"4","key":"ref8","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1097\/01.sla.0000157265.85388.a1","article-title":"Intestine Transplant Registry. 2003 report of the intestine transplant registry: a new era has dawned","volume":"241","author":"Grant D","year":"2005","journal-title":"Ann Surg"},{"issue":"3","key":"ref9","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1097\/00005176-200403000-00006","article-title":"Irreversible intestinal failure","volume":"38","author":"Goulet O","year":"2004","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"5","key":"ref10","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1111\/j.1572-0241.2007.01125.x","article-title":"Nutrition and quality of life following small intestinal transplantation","volume":"102","author":"O\u2019Keefe SJ","year":"2007","journal-title":"Am J Gastroenterol"},{"issue":"3","key":"ref11","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1097\/MOT.0b013e32832ac0f5","article-title":"Update on intestinal rehabilitation after intestinal transplantation","volume":"14","author":"Gupte GL","year":"2009","journal-title":"Curr Opin Organ Transplant"},{"issue":"4 Pt 2","key":"ref12","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1111\/j.1600-6143.2010.03044.x","article-title":"Intestine transplantation in the United States, 1999-2008","volume":"10","author":"Mazariegos GV","year":"2010","journal-title":"Am J Transplant"},{"issue":"3","key":"ref13","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1054\/clnu.2000.0380","article-title":"Clinical, social and rehabilitation status of long-term home parenteral nutrition patients: results of a European multicentre survey","volume":"20","author":"Van Gossum A","year":"2001","journal-title":"Clin Nutr"},{"issue":"2","key":"ref14","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/0016-5085(95)90321-6","article-title":"Current use and clinical outcome of home parenteral and enteral nutrition therapies in the United States","volume":"109","author":"Howard L","year":"1995","journal-title":"Gastroenterology"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"S147","DOI":"10.1053\/j.gastro.2005.12.004","article-title":"Intestinal replacement therapy: timing and indications for referral of patients to an intestinal rehabilitation and transplant program","volume":"130","author":"Fishbein TM","year":"2006","journal-title":"Gastroenterology"},{"issue":"2","key":"ref16","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.transproceed.2004.01.110","article-title":"Demographic of short gut syndrome: increasing demand is not followed by referral of potential candidates for small bowel transplantation","volume":"36","author":"Bakonyi A","year":"2004","journal-title":"Transplant Proc"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1097\/00000658-195910000-00001","article-title":"The physiological response of the small bowel of the dog to ischemia including prolonged in vitro preservation of the bowel with successful replacement and survival","volume":"150","author":"Lillehei RC","year":"1959","journal-title":"Ann Surg"},{"issue":"2","key":"ref18","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1111\/j.1600-6143.2006.01649.x","article-title":"Ten-year experience in porto-caval hemitransposition for liver transplantation in the presence of portal vein thrombosis","volume":"7","author":"Selvaggi G","year":"2007","journal-title":"Am J Transplant"},{"issue":"10","key":"ref19","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1001\/jama.1989.03420100085029","article-title":"Transplantation of multiple abdominal viscera","volume":"261","author":"Starzl TE","year":"1989","journal-title":"JAMA"},{"issue":"8683","key":"ref20","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/0140-6736(90)90275-A","article-title":"Successful small-bowel\/liver transplantation","volume":"335","author":"Grant D","year":"1990","journal-title":"Lancet"},{"issue":"1","key":"ref21","first-page":"87","article-title":"Long survival in rats after multivisceral versus isolated small-bowel allotransplantation under FK 506","volume":"110","author":"Murase N","year":"1991","journal-title":"Surgery"},{"issue":"6","key":"ref22","doi-asserted-by":"crossref","first-page":"95","DOI":"10.5500\/wjt.v2.i6.95","article-title":"Where are we at with short bowel syndrome and small bowel transplant","volume":"2","author":"Yildiz BD","year":"2012","journal-title":"World J Transplant"},{"issue":"4","key":"ref23","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1097\/01.sla.0000183347.61361.7a","article-title":"100 Multivisceral Transplants at a Single Center","volume":"242","author":"Tzakis AG","year":"2005","journal-title":"Ann Surg"},{"issue":"3","key":"ref24","first-page":"150","article-title":"Intestinal transplantation: Who, when and how? A general overview","volume":"88","author":"Roskott AM","year":"2009","journal-title":"Rev Med (S\u00e3o Paulo)"},{"issue":"1","key":"ref25","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1111\/j.1600-6143.2008.02459.x","article-title":"Allospecific CD154+ T cells associate with rejection risk after pediatric liver transplantation","volume":"9","author":"Ashokkumar C","year":"2009","journal-title":"Am J Transplant"},{"issue":"3","key":"ref26","first-page":"223","article-title":"Small bowel transplantation","volume":"26","author":"P\u00e9cora RA","year":"2013","journal-title":"Arq Bras Cir Dig"},{"issue":"1","key":"ref27","first-page":"39","article-title":"Transplantation of the small intestine. Case report","volume":"24","author":"Okumura M","year":"1969","journal-title":"Rev Hosp Clin Fac Med Sao Paulo"},{"key":"ref28","series-title":"Tratado de cl\u00ednica cir\u00fargica","first-page":"2080","volume-title":"Transplante intestinal","author":"Galv\u00e3o FH","year":"2005"},{"issue":"6","key":"ref29","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1097\/SLA.0b013e31825429c0","article-title":"Multivisceral transplantation for diffuse portomesenteric thrombosis","volume":"255","author":"Vianna RM","year":"2012","journal-title":"Ann Surg"}],"container-title":["Einstein (S\u00e3o Paulo)"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/eins\/v13n1\/1679-4508-eins-13-1-136.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,7]],"date-time":"2022-05-07T11:55:50Z","timestamp":1651924550000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1679-45082015000100024&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,3]]}},"alternative-id":["S1679-45082015000100024"],"URL":"https:\/\/doi.org\/10.1590\/s1679-45082015rw3155","relation":{},"ISSN":["1679-4508"],"issn-type":[{"value":"1679-4508","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3]]}}}