Introduction-background Short-term graft and patient survival after Intestinal Transplantation continues to improve (1). However, over the longer term (1-5 years), patient survival remains impeded by late graft failures. Typically, the presentation is that of a patient, long after discharge from the hospital and who was previously well, presenting unexpectedly with an irreversible rejection or other advanced intestinal pathology. The problem is that over the short term (6-12 months after Transplantation), endoscopic analysis of biopsies through the open graft ileostomy provides easy access to the graft. However, after the graft ileostomy is closed, these procedures are impractical, costly and carry a significant risk (sedation, hemorrhage, perforation). This is further complicated by the location of many patients at some distance from a specialized center. Therefore, surveillance endoscopies and biopsies cannot be performed frequently after the first few months following transplantation. Symptoms and relevant clinical findings are the only available warnings and frequently make their first appearance when the pathology is irreversible.
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