ABSTRACT
Small bowel transplantation represents the physiologic alternative to total parenteral nutrition (TPN), and it has recently become a valid therapeutic option for patients with intestinal failure, with one-year graft survival rates now higher than 80% (1). However, this procedure is still associated with a relatively high rate of complications. A higher incidence of infections, acute rejection, and post-transplant lymphoproliferative disorder (PTLD) is observed following intestinal transplantation compared with the transplantation of other organs (1-5). These may be, at least in part, the consequence of the peculiarity of this graft that contains gut-associated lymphoid tissue and potential pathogenic enteric flora. Furthermore, in these patients, the existing disease and the relative malnutrition may predispose them to infectious complications. Additionally, other factors associated with the procedure, such as laparotomy, preservation injury, abnormal motility, lymphatic disruption, systemic venous drainage, antibiotic therapy, and the potent immunosuppressive agents can all be implicated in the development of infections in these patients.
