Sammanfattning
Background. Patients with chronic intestinal failure are treated primarily with parenteral nutrition, often for many years. If serious complications arise in connection with intravenous nutritional therapy, intestinal and multivisceral transplantation can be considered. We have established a collaboration with Sahlgrenska University Hospital in Gothenburg, Sweden, and the Jackson Memorial Hospital in Miami, USA, to provide an option for Norwegian patients with chronic intestinal failure.
Material and method. Long-term study of seven patients, five in Gothenburg and two in Miami, with chronic intestinal failure who underwent intestinal/multivisceral transplantation (stomach, duodenum, pancreas and small intestine) in the period 2001-2009. At the same time, liver and kidney transplantations were performed on six and two patients, respectively.
Results. Four of seven patients are alive and their general condition is satisfactory 24-120 months after the transplantation. The graft function is satisfactory, so that the patients' food intake is mainly oral. Three patients died following a serious infection one, ten and 24 months, respectively, after transplantation took place.
Interpretation. Intestinal and multivisceral transplantation is a demanding and expensive treatment. Lifelong multi-disciplinary follow-up of the patients is necessary after the transplantation in order to ensure early diagnosis of rejection and infections. Collaboration with international centres has provided Norwegian patients with chronic intestinal failure with a treatment option that is not available in Norway.