Living donor small bowel transplantation: Literature review 2003–2006 Paper 1: Successful treatment of trauma-induced short bowel syndrome with early living related bowel transplantation. Benedetti E, Testa G, Sankary H, Sileri P, Bogetti D, Jarzembowski T, Abcarian H. J Trauma 2004:57:164–170. This paper reports a case series of trauma induced ultra-short bowel syndrome successfully treated with early living related small bowel transplantation. Trauma is the third most com- mon cause of intestinal transplantation in the adult population (40% of the total). Short bowel syndrome represents a rare complication of abdominal trauma. TPN is the standard long- term management offered to these patients at the price of high costs, high rate of infectious complications, central vein thrombosis, increased risk of liver failure, and an overall poor quality of life. In this setting bowel transplantation has been suggested as a valuable and cost effective alternate strategy for patients with life-threaten- ing complications from TPN. The preliminary results reported in this study seem to support the theoretical benefits of the living donation, inclu- ding elimination of the waiting list time, better HLA matching, and decreased rate of infectious complication (probably due to significantly decreased cold ischemia time and its beneficial effect on preventing bacterial translocation). The Authors reported in fact only one episode of viral enteritis and a late episode (>one yr) of acute rejection in the context of non-compliance with the immunosuppressive therapy. The recipients reported quality of life was very satisfactory. Comment: This is an interesting study suggest- ing a new approach for treatment of trauma related ultra-short bowel syndrome (only duode- num and sigmoid colon preserved). This experi- ence demonstrates that living related bowel transplantation may attain good outcomes in terms of graft and patient survival and quality of life. However, the small size of the sample and the short follow-up time interval represent an obvious limitation of the study. Paper 2: Living related small bowel transplantation in children: 3-dimensional computed tomography donor evaluation. Panaro F, Testa G, Balakrishnan N, Rao B, Bogetti D, Jarzemboski T, Sammartino C, Sankary H, Benedetti E. Pediatr Transplant 2004:8:65–70. This study compared outcomes of standard angiography vs. the newer angio-CT with 3–D reconstruction in evaluating small bowel donor’s vascular anatomy. Four potential donors were studied with each technique. Adverse reactions, Gangemi A, Benedetti E. Living donor small bowel transplantation: Literature review 2003–2006. Pediatr Transplantation 2006: 10: 875–878. Ó 2006 Blackwell Munksgaard Abstract: The experience with living donors for intestinal transplanta- tion is limited. However, Intestinal Registry data suggest that the out- comes of the procedure are comparable with those obtained with intestinal transplant from deceased donors. In selected cases, this strategy may have a role in the treatment of patients with irreversible intestinal failure suffering life-threatening complications from total parenteral nutrition. The present review covers most of the published data on this topic between 2003 and 2006, with special reference to living donor intestinal transplantation of pediatric recipients. A. Gangemi and E. Benedetti Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA Key words: living donor transplant – intestinal transplant – short gut syndrome – total parenteral nutrition Enrico Benedetti, MD, FACS, Division of Transplantation, University of Illinois at Chicago, 840 S. Wood St., Chicago, IL 60612, USA Tel.: 312 996 6771 Fax: 312 413 3483 E-mail: enrico@uic.edu Accepted for publication 16 August 2006 Abbreviations: TPN, total parenteral nutrition; HLA, human leukocyte antigen; UNOS, United Network of Organ Sharing; LDBTx, living-donor bowel transplantation. Pediatr Transplantation 2006: 10: 875–878. Copyright Ó 2006 Blackwell Munksgaard Pediatric Transplantation DOI: 10.1111/j.1399-3046.2006.00614.x 875