Intestinal twin-to-twin transplant for short gut: Review of the literature and discussion of a complex case


Submitted: 9 June 2022
Accepted: 19 September 2022
Published: 18 October 2022
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Authors

Paediatric Intestinal Transplantation (IT) presents the highest mortality on the waiting-list due to anatomical disproportion. Living-Donor IT (LDIT) offers the best advantages and when performed among identical monozygotic twins, it also benefits from unique immunology. According to MEDLINE/Pubmed, twin-to-twin LDIT has been performed in seven cases (6:7 males, median age of 32 years). None of the patients received immunosuppression postoperatively. Only one paediatric twinto- twin LDIT was carried out with a 160-cm mid-ileum tract: an interposed 4/5-cm arterial graft was required to ensure a tensionfree anastomosis to the anterior wall of the infra-renal abdominal aorta. In contrast, venous anastomosis was done directly to the inferior cava vein. We present a case for debate of a 13- month-old SBS patient where a twin-LDIT was discussed with parents, who decided to wait after careful analysis and ethical considerations.


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Ugolini, S., Coletta, R., & Morabito, A. (2022). Intestinal twin-to-twin transplant for short gut: Review of the literature and discussion of a complex case. La Pediatria Medica E Chirurgica, 44(2). https://doi.org/10.4081/pmc.2022.287

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