The isolated intestinal transplantation (IITx), liver-intestinal transplantation (L-ITx), multivisceral transplantation (MVTx), and modified MVTx

Abstract

Organ transplantation, an ever-evolving medical field, has introduced various visceral transplantation procedures based on the unique needs of patients with end-stage organ diseases. The choice between four primary procedures — isolated intestinal transplantation (IITx), liver-intestinal transplantation (L-ITx), multivisceral transplantation (MVTx), and modified MVTx — is contingent on specific medical indications, the organs involved, and the nature of the underlying disease. IITx is typically recommended for cases like short bowel syndrome without liver complications or certain vascular thromboses isolated to the intestines. This procedure mainly involves transplanting the donor's small intestine. L-ITx, on the other hand, addresses conditions like short bowel syndrome with liver complications and necessitates the transplantation of both the liver and intestine, demanding extensive vascular modifications. MVTx is a more comprehensive procedure targeting diffuse portomesenteric thrombosis, multi-organ failures, or abdominal tumors affecting multiple organs. This method requires transplantation of multiple organs like the stomach, liver, pancreas, and small bowel, depending on the specific case. The modified MVTx mirrors the MVTx but is opted for when the liver functions sufficiently and thus, excludes liver transplantation. Deciding among these transplantation options requires a holistic, multidisciplinary approach that takes into account the patient's unique health condition and disease progression. Advancements in surgical techniques, coupled with enhanced post-operative care and modern immunosuppressive regimens, have notably elevated the success rates of these transplantations over the past years.