Introduction

INTRODUCTION

The first reported intestine-containing transplant in humans was performed in 1966, when a short segment of duodenum was included in a pancreas transplant. This was followed by attempts to transplant more substantial amounts of intestine, but these did not result in long-term survival. It was not until 1988 that the first ‘successful’ intestine-containing transplant was reported. At this time intestinal transplants were a rarity but with increasing experience (both surgical and immunological) out comes have improved, making intestinal transplantation a rel atively routine procedur e. Changes in immunosuppression regimes (depleting Burrill Bernard Crohn , 1884–1983, gastroenterologist, Mount Sinai Hospital, New Y ork, NY , USA, described regional ileitis in 1932. antibodies and tacrolimus) have improved rates of rejection, a complication that is di ffi cult to control and can be life- threatening. In 1996 the International Intestinal Transplant Registry was established and reported a total of 180 transplants per - formed in 25 centres worldwide. By 2019 this number was over 4100, with almost doub le the number of active centres. The majority of transplants have been performed in the USA and Europe, with the most prolific units performing o ver 10 adult transplants per year. With improvements in the management of paediatric intes - tinal failure the number of multivisceral and intestinal trans - plants in this group has fallen.

Both the medical and surgical complications associated • with intestinal transplantation The outcomes associated with intestinal transplantation •