ABSTRACT
Intestinal transplantation was —rst described in an animal model in 1951 by Mueller et al. [1]. However, it was not until 1967 that the —rst attempt at intestinal transplantation in humans was reported [2]. With the introduction of parenteral nutrition (PN) in 1968 by Dudrick, patients with intestinal failure (IF) had a new treatment which provided them life-saving nutrition [3]. Because of this major advance, and the unacceptably poor transplant outcomes in the precalcineurin inhibitor era, clinical intestinal transplantation was not reconsidered until the introduction of cyclosporine (the —rst calcineurin inhibitor) in 1980 [4-6]. The —rst successful combined liver-intestine transplant in a patient with short bowel syndrome (SBS) was reported in 1990 [7]. Despite the clear demonstration of the technical feasibility of intestinal transplantation, posttransplant survival still remained comparatively poor until the introduction of tacrolimus in 1990 [8]. Results of intestinal transplantation slowly improved through the 1990s due to a combination of technical improvements as well as a better understanding of the management of intestinal rejection. The 2001 American Society of Transplantation position paper established intestinal transplantation as an option for those who could no longer be sustained on PN [9]. In 2001, the Centers for Medicare and Medicaid Services approved Medicare coverage of intestinal transplantation for patients with complications from irreversible IF. Data from the Intestinal Transplant Registry show that between 1985 and 2009 there were 2291 intestine transplants in 2061 patients at 86 centers [10].
