Objective: The case report about the longest survival of small bowel transplantation and their perioperative complications

Material and method: Male, 22 years, which began in childhood due to a pyloric hipertrophic estenosis and subsequently evolves with intestinal oclusion leading to several procedures in the correction of intestinal fistulas and adherences, resulting in six surgical procedures and ultrashort bowel syndrome by several intestinal resections The patient was submitted at first to parenteral nutrition (PN), in second time to intestinal transit reconstruction and finally isolated intestinal transplant The evaluation parameters were: various blood test including liver, kidney function and electrolytes level, radiological exams, ultrasound, echocardiography, vascular color doppler, endoscopy, colonoscopy and daily evaluation by multidisciplinary team

Results: The patient presented severe malnutrition and was unable to walk with Body Mass Indice (BMI)=11,18 Kg/m2, B1 hypovitaminosis (Beriberi) characterized by cardiac disfunction, thrombosis of various central veins caused by recurrent infections and liver test show moderate cholestasis After six months of nutritional support and three months on post operative period of intestinal reconstruction , the BMI increased to18,1 Kg/m2 and return of normal cardiac function Then was submitted a Isolated Intestinal Transplantation on the fourth day of december/2017, presenting the following complications: kidney failure, lymphatic fistula, jejunal bleeding and pericardial effusion. But he weaned from NP completely in two months after transplant and reached independent oral feeding.

Conclusion: This case teaches us that despite several severe perioperative complications mainly malnutrition, many central line infections with thrombosis, considered initially palliative treatment, however had excellent evolution and good quality of life until this moment.