Belgian multicenter experience with intestinal transplantation

Summary Intestinal transplantation ( IT x) has evolved from an experimental procedure toward a clinical reality but remains a challenging procedure. The aim of this survey was to analyze the multicenter Belgian IT x experience. From 1999 to 2014, 24 IT x in 23 patients were performed in Belgium, divided over five centers. Median recipient age was 38 years (8 months–57 years); male/female ratio was 13/10; six were children; and 17 adults. Intestinal failure was related to intestinal ischemia ( n  = 5), volvulus ( n  = 5), splanchnic thrombosis ( n  = 4), Crohn ( n  = 2), pseudo‐obstruction ( n  = 2), microvillus inclusion ( n  = 2), Churg‐Strauss ( n  = 1), necrotizing enterocolitis ( n  = 1), intestinal atresia ( n  = 1), and chronic rejection ( n  = 1). Graft type was isolated IT x ( n  = 9), combined liver‐ IT x ( n  = 11) and multivisceralTx ( n  = 4). One was a living donor‐related transplantation and five patients received simultaneously a kidney graft. Early acute rejection occurred in 8; late acute rejection in 4; and chronic rejection in 2. Two patients developed a post‐transplant lymphoproliferative disease. Nine patients have died. Among 14 survivors at last follow‐up, 11 have been transplanted for more than 1 year. None of the latter has developed renal failure, and all were nutritionally independent with a Karnofsky score > 90%. One‐/five‐year patient and graft survivals were 71.1%, 62.8%, 58.7% and 53.1%, respectively. Based on this experience, IT x has come of age in Belgium as a lifesaving and potentially quality of life restoring therapy.