CIT

Chronic Intestinal Transplantation
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Chronic Intestinal Transplantation (CIT) is a surgical procedure performed to replace a diseased or non-functioning intestine with a healthy intestine from a donor. This procedure is typically considered when a patient has intestinal failure and cannot be sustained on parenteral nutrition alone.

Indications

CIT is indicated in patients with severe short bowel syndrome, chronic intestinal pseudo-obstruction, or other conditions leading to irreversible intestinal failure. Patients who develop life-threatening complications from long-term parenteral nutrition, such as liver failure or recurrent sepsis, may also be candidates for transplantation.

Procedure

The transplantation process involves the removal of the diseased intestine and the implantation of a donor intestine. The procedure is complex and requires careful matching of donor and recipient tissue types to minimize the risk of graft rejection.

Preoperative Evaluation

Patients undergo extensive evaluation before being listed for transplantation. This includes assessment of nutritional status, liver function, and overall health. Psychological evaluation is also important to ensure the patient can adhere to the rigorous post-transplant care regimen.

Surgical Technique

The surgical procedure involves anastomosing the donor intestine to the recipient's gastrointestinal tract. Vascular connections are established to ensure adequate blood supply to the transplanted organ. The surgery can take several hours and requires a highly skilled surgical team.

Postoperative Care

After the surgery, patients require intensive monitoring in a specialized transplant unit. Immunosuppressive therapy is initiated to prevent rejection of the transplanted intestine. Regular follow-up is necessary to monitor for complications such as rejection, infection, and graft-versus-host disease.

Complications

Complications of CIT can include:

• Acute or chronic rejection
• Infections due to immunosuppression
• Graft-versus-host disease
• Anastomotic leaks or strictures

Prognosis

The prognosis for patients undergoing CIT has improved significantly with advances in surgical techniques and immunosuppressive therapies. Long-term survival rates have increased, and many patients can achieve a good quality of life post-transplant.

Research and Future Directions

Ongoing research in CIT focuses on improving immunosuppressive regimens, enhancing graft survival, and developing bioengineered intestines. Advances in tissue engineering and regenerative medicine hold promise for future treatment options.

Also see

• Intestinal failure
• Parenteral nutrition
• Transplant rejection
• Graft-versus-host disease

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