Introduction: Intestinal transplant (ITx) remains the last therapeutic alternative for patients (pts) with intestinal failure (IF). Although pt and graft survival have improved overtime, there are few reports of the long term outcomes of individual pts surviving more than 10 years with functional grafts; there is no long term results report from Latin-America.

Aim: to describe the outcome of those pts underwent ITx at our center and have more than 10 years survival with functional graft.

Materials and methods: This is a retrospective analysis of ITx long term survivors starting in May 2006. Diagnoses, ITx indications, incidence of acute and chronic rejection, complications related to immunosuppression (IS) and social reinsertion over time are reported.

Results: 5/49 (10.2%) ITx done at our center, have more than 10 year survival with a functional graft. Four of them are currently adults, but 3 were less than 18 years of age at the time of ITx; 3 are male. All pts had Short Bowel Syndrome (SBS). The indications for ITx were intestinal failure associated liver disease (40%), lack of central venous accesses (40%), and recurrent line sepsis (20%). The mean duration of hospital stay after ITx was 39.6±18.02 days (4 isolated ITx, 1 combined Liver-ITx). All pts presented at least 1 episode of acute cellular rejection (mean 2.8±1.78); 11 mild, 1 moderate, 2 severe. 7 episodes occurred during the first year post ITx and the rest occurred between the first and the fifth year post ITx. None of the pts developed chronic rejection. Complications related to IS therapy are chronic renal failure requiring kidney transplant (1); diabetes (1); bilateral aseptic necrosis of the femoral head (2) The 5 patients suffered infectious complications episodes (8 viral, 16 bacterial, 1 mycotic, 1 parasitic). One pt had visceral Kaposi's sarcoma. All the long term survivors were able to resume their social and labour activities (3 are students, 1 is a nurse, 1 is a builder); one pt had a child after ITx.

Conclusions: ITx has become feasible option in the Latin- American region with long term survival under the care of a multidisciplinary comprehensive team. Early diagnosis and aggressive management of post ITx complications is required in order to increase the long term survival with a functional graft.