It is estimated that 10 to 20 percent of all patients started on homePEN will remain dependent on homePEN indefinitely. A limited number of patients may be candidates for non-transplant surgical options. An isolated small bowel graft is typically recommended when a patient develop has lost venous access. Multivisceral transplants are for patients with locally aggressive tumors that can only be removed by a massive evisceration of the abdominal organs. Intestinal transplantation in humans proved clinically feasible in the late 1980's.
Research shows the procedure is effective, but has considerable morbidity and mortality.
Rejection episodes are relatively frequent, and patients develop lymphoproliferative disease and serious infections such as chronic cytomegalovirus or Epstein Barr virus. About half of the patients receiving intestinal transplants survive five years or more. This prognosis is somewhat better in young people ages 2 to 17. Analyzing the Data In deciding whether to cover SBT, HCFA considered several studies and two technology assessments. This article included data on 272 transplants in 269 patients from 33 intestinal transplant programs.