Small bowel transplantation

Purpose of review The complexities of small bowel transplantation have made its successful clinical application a significant challenge. Many strategies that have been highly successful in improving the outcomes of other types of transplantations have had limited success with small bowel transplantations. Despite this, the results have slowly been improving, primarily because of better overall clinical acumen based on a better understanding of the unique complexities of small bowel transplantation. This has evolved primarily as a result of ongoing clinical observation with resultant modifications in clinical management practices. Recent findings Although basic science research efforts played a limited role in the early clinical development of small bowel transplantation, they are becoming increasingly important in defining the unique immunologic, physiologic, and microbiologic problems that limit further progress. Summary This review summarizes some of the major issues that make small bowel transplantation unique and challenging and the clinical and basic science research that has been done in an attempt to clarify and resolve these issues.