HC-FMUSP is one of the world’s pioneer of isolated intestinal transplantation (IIT) performed by the living legend Masayuki Okumura (1)and currently is the public Hospital reference for Intestinal and Multivisceral Transplantation (IMT) in Brazil. In 2014, HCFMUSP restart IMT program, inspired by animal research (2-6) and financed by the Government. Here we show five cases of IMT performed at HC-FMUSP.Cases: ONE A 38 years old male underwent IIT in 1968, 10 days after a massive enterectomy due to mesenteric artery thrombosis. The recipient survived for twelve days (one of the longest survival in that age) and died due to uncontrolled rejection. TWO: A 12 years old female underwent IIT in 1969, 34 days after a massive enterectomy due volvulus. The patient survived for five days and die due to uncontrolled rejection. THREE: A 33 years old, male, with a neuroendocrine tumor in the pancreas involving mesenteric vessels and multiple liver metastasis received a multivisceral graft in 2014, survived for five days and died due to uncontrolled bleeding. FOUR: 51 year old male presenting liver cirrhosis due to alcohol with a complex portal vein thrombosis (grade IV) received a multivisceral graft in May of 2015, survived for 30 days and died due to a liver needle biopsy that caused a progressive internal bleeding and liver failure. FIVE. A 21 year old male presenting short bowel syndrome due to mesenteric torsion received isolated intestinal transplantation in 2017. Intestinal reconstruction was performed four months after the transplantation and he is currently very well, gained nine Kg of body weight and accomplished total oral feeding autonomy. This case is the longer survival of isolated intestinal transplantation in Brazil (14 months). Currently we have 15 patient referral and five patients listed for IMT, three for isolated and two for multivisceral. The main obstacle for IMT in Brazil is the lack of suitable donors (7).Conclusion: HCFMUSP is world’s pioneer in IMT and currently have achieved long term survival in a case of intestinal transplantation. Improvements in donor care would improve this actively in Brazil.

References:

Okumura M et al. Clinics. 1969;24(1):39-54.

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Galvão FH, et al. Tech Coloproctol. 2009;13(1):55-9.

Galvão FH, et al. Xenotransplantation. 2008;15(3):184-90.

Galvão FH, et al. Transplantation. 2005;27;80:1522-3.

Calil IL, et al. Transplant Proc. 2016;48(2):450-2.