SUMMARY

SUMMARY

• Multivisceral and intestinal transplantation remains a complex and uncommon treatment, however it can be life-saving. The risks are high but with improvements in surgical techniques, - especially the introduction of preoperative embolisation, the intraoperative risks have improved. With this and a better understanding of how to manage the varied and complex postoperative complications, outcomes continue to improve. Intestinal transplantation for patients on PN was previously reserved for those with life-threatening complications of this treatment. Outcomes have improved such that, in certain cir - cumstances , it can now be o ff ered to improve quality of life. - With time, improvement in patient management may allow intestinal transplantation to fulfil the same role for patients on PN as kidney transplantation currently o ff ers those on dialysis: to improve both quality and length of life. an T he need for liver-containing grafts will always remain for those who require a liver transplant but are unable to have a single-organ transplant for anatomical reasons. W ith improve - ments in liver functional assessment and increasing awareness - of the possibility of earlier intestinal transplantation, it may be - possible to reduce and hopefully eliminate the need f or liver transplantation for IFALD. The benefits for the individual in terms of improved survival and also the population with better organ utilisation are substantial. The main cause of death in multivisceral and intestinal - transplant recipients remains sepsis. This is frequently associ - - ated with a preceding episode of severe acute cellular rejection and so further dev elopments in immunosuppression regimens will be necessary to continue to improve patient outcomes.