ABSTRACT

Intestinal and multivisceral transplantation can be a life-saving therapy for patients with complications from the treatment of intestinal failure. Indications for this highly specialised type of transplant are broadening to include acute vascular catastrophes and some otherwise irresectable intra-abdominal tumours. With improvements in the management of paediatric intestinal failure the number of multivisceral and intestinal transplants in this group has fallen. Indications for intestinal transplantation continue to change and now include to facilitate the resection of some tumours. Acute widespread splanchnic ischaemia is a rare but growing indication for super-urgent intestinal and multivisceral transplantation as well as other acute abdominal catastrophes. The decision regarding the type of transplant to be performed is dependent on a variety of patient factors. When an enteric leak does occur, the immunosuppressed state of the patient can result in an atypical presentation.