Reviews
18 October 2022
Vol. 44 No. 2 (2022)
https://doi.org/10.4081/pmc.2022.287

Intestinal twin-to-twin transplant for short gut: Review of the literature and discussion of a complex case

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Intestinal failure, short bowel syndrome, Longitudinal Intestinal Lengthening and Tailoring (LILT), tissue donors, twins
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Authors

Sara Ugolini
sara.ugolini@mft.nhs.uk
https://orcid.org/0000-0001-7150-6082
Cardiothoracic Surgery Department, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
Riccardo Coletta
Paediatric Surgery Unit, A. Meyer Children’s Hospital of Florence, Italy; University of Salford, Salford UK School of Environment and Life Science, United Kingdom.
Antonino Morabito
https://orcid.org/0000-0002-5323-3620
Paediatric Surgery Unit, A. Meyer Children’s Hospital of Florence, Italy; Department of NEUROFARBA, University of Florence, Italy.

Paediatric Intestinal Transplantation (IT) presents the highest mortality on the waiting-list due to anatomical disproportion. Living-Donor IT (LDIT) offers the best advantages and when performed among identical monozygotic twins, it also benefits from unique immunology. According to MEDLINE/Pubmed, twin-to-twin LDIT has been performed in seven cases (6:7 males, median age of 32 years). None of the patients received immunosuppression postoperatively. Only one paediatric twinto- twin LDIT was carried out with a 160-cm mid-ileum tract: an interposed 4/5-cm arterial graft was required to ensure a tensionfree anastomosis to the anterior wall of the infra-renal abdominal aorta. In contrast, venous anastomosis was done directly to the inferior cava vein. We present a case for debate of a 13- month-old SBS patient where a twin-LDIT was discussed with parents, who decided to wait after careful analysis and ethical considerations.

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Europe PMC
Morabito A, Ugolini S, Cianci MC, Coletta R. Current surgical concepts and indications in the management of the short bowel state: A call for the use of multidisciplinary intestinal rehabilitation programs. Children 2021;8:654. DOI: https://doi.org/10.3390/children8080654
Goulet O, Ruemmele F. Causes and management of intestinal failure in children. Gastroenterology 2006;130:S16-28. DOI: https://doi.org/10.1053/j.gastro.2005.12.002
Bishay M, Pichler J, Horn V, et al. Intestinal failure-associated liver disease in surgical infants requiring long-term parenteral nutrition. J Pediatr Surg 2012;47:359-62. DOI: https://doi.org/10.1016/j.jpedsurg.2011.11.032
Yap JYK, Roberts AJ, Bines JE. Paediatric intestinal failure and transplantation. J Paediatr Child Health 2020;56:1747-53. DOI: https://doi.org/10.1111/jpc.15052
Tzvetanov IG, Tulla KA, D’Amico G, Benedetti E. Living donor intestinal transplantation. Gastroenterol Clin North Am 2018;47:369-80. DOI: https://doi.org/10.1016/j.gtc.2018.01.008
Gazit VA, Swietlicki EA, Liang MU, et al. Stem cell and niche regulation in human short bowel syndrome. JCI Insight 2020;5:e137905. DOI: https://doi.org/10.1172/jci.insight.137905
Lauro A, Panaro F, Iyer KR. Analyse de l’activité actuelle de transplantation intestinale en Europe et aux États-Unis. J Visceral Surg 2017;154:105-14. DOI: https://doi.org/10.1016/j.jchirv.2016.08.008
Celik N, Mazariegos G v., Soltys K, et al. Pediatric intestinal transplantation. Gastroenterol Clin North Am 2018;47:355-68. DOI: https://doi.org/10.1016/j.gtc.2018.01.007
Horslen SP, Smith JM, Weaver T, Cafarella M, Foutz J. OPTN/SRTR 2020 Annual Data Report: Intestine. Am J Transplant 2022;22:310-349. DOI: https://doi.org/10.1111/ajt.16992
Busch AM. Current status of small bowel transplantation a case study of transplant between identical twins. Gastroenterol Nurs 1999;22:170-4. DOI: https://doi.org/10.1097/00001610-199907000-00006
Berney T, Genton L, Buhler LH, et al. Five-year follow-up after pediatric living related small bowel transplantation between two monozygotic twins. Transplantation Proceedings 2004;36:316-8. DOI: https://doi.org/10.1016/j.transproceed.2004.01.103
Genton L, Raguso CA, Berney T, et al. Four year nutritional follow up after living-related small bowel transplantation between monozygotic twins. Gut 2003;52:659-62. DOI: https://doi.org/10.1136/gut.52.5.659
Morel P, Kadry Z, Charbonnet P, et al. Paediatric living related intestinal transplantation between two monozygotic twins: A 1-year follow-up. Lancet 2000;355:723-4. DOI: https://doi.org/10.1016/S0140-6736(99)05789-X
Wu G, Zhao Q, Wang M, et al. Identical twin small-bowel transplantation without maintenance immunosuppression: A 5-year follow-up and literature review. Transplant Direct 2018;4:e374. DOI: https://doi.org/10.1097/TXD.0000000000000807
Gheza F, di Bella C, Tulla K, et al. Small bowel transplantation in identical twins a video vignette. Colorectal Dis 2018;20:934. DOI: https://doi.org/10.1111/codi.14346
Schena S, Testa G, Setty S, et al. Successful identical-twin living donor small bowel transplant for necrotizing enterovasculitis secondary to Churg-Strauss syndrome. Transplant International 2006;19:594-7. DOI: https://doi.org/10.1111/j.1432-2277.2006.00316.x
Morris JA, Johnson DL, Rimmer JA, et al. Identical-twin small-bowel transplant for desmoid tumour. Lancet 1995;345:1577-8. DOI: https://doi.org/10.1016/S0140-6736(95)91130-8
Cicalese L, Sileri P, Rastellini C, et al. Living related small bowel transplantation. Graft 2008;4:526-34. DOI: https://doi.org/10.1177/152216280100400801
Calne RY, Friend PJ, Middleton S, et al. Intestinal transplant between two of identical triplets. Lancet 1997;350:1077-8. DOI: https://doi.org/10.1016/S0140-6736(05)70458-X

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Intestinal twin-to-twin transplant for short gut: Review of the literature and discussion of a complex case. (2022). La Pediatria Medica E Chirurgica, 44(2). https://doi.org/10.4081/pmc.2022.287
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