Histopathological study of 7 intestinal grafts lost in a series of 16 adult transplants. Hospital 12 Octubre. Madrid. Method: We studied 4 explants and 2 autopsy. The autopsy was not authorized in one death. Results: Seven grafts were lost in 6 patients (3 multivisceral). Two types of failure were seen. A) local: 3 severe acute rejections (AR) (days 77, 158, 511) and 1 lymphoproliferative syndrome (LPS) in day 148; B) systemic: 3 sepsis (days 31,88,161). AR showed 3 types of morphology: ulcerative, pseudomembranous and with disappearance of the villi preserving the crypts. LPS was a high-grade B lymphoma and affected the graft and the lymph mesenteric nodes with venous thrombosis that cause ischemic necrosis. The 3 sepsis were due to acinetobacter, to adenovirus in the graft and pulmonary aspergillosis and to pseudomona aeruginosa with necrohemorrhagic pancreatitis. Conclusion: 1-The incidence of IGL was 44 %. 2-The cause of IGL was local (AR and LPS) in 57 % and sepsis in 43 %. 3-Severe AR was the most frequent cause of failure. 4-Histological examination properly determine and document the causes of IGL.