Intestinal Transplantation

Continuity with its environment makes the intestine a unique abdominal organ. Apart from its nutritional role, it contains a large amount of lymphoid tissue and intimately interacts with microbial flora. The lymphoid element within the gut has a necessary, complex immunological role, so it was always deemed an intuitive barrier to intestinal transplantation. Nevertheless, Richard Lillehei at the University of Minnesota saw the potential for transplanting the small intestine in patients with intestinal failure and performed the first such transplant in the 1960s. Early refinements in surgical technique were followed by advances in immunosuppression and a better appreciation of post-transplant care; today, an intestinal transplant (ITx) is a well-established option in clinical practice.