Resumo

SANCHEZ-ARIAS, Mario; LOPEZ-JARA, Vanessa  e  ARAYA-CHAVARRIA, Sheila. First small bowel transplant in Costa Rica. Acta méd. costarric [online]. 2017, vol.59, n.1, pp.38-41. ISSN 0001-6002.

The first successful small bowel transplant was performed in1988 in Germany by Dr Deltz and co workers. However in Costa Rica it was until december 2013 that was done the first small bowel transplant at the Dr. Rafael Angel Calderon Guardia Hospital. It also became the first small bowel transplant in Central America.

This report the case of a young male that had a stabb wound in his abdomen and developed a massive mesenteric ischemia with vascular compromise. The allograft was procured from a cadaveric donor. The recipient received immunosuppression with baxiliximab, tacrolimus, prednisone y micophenolate mofetil. Due to surgical complications the patient underwent 7 more surgeries, he developed tacrolimus induced renal dysfunction, myelotoxicity and iliac deep venous thrombosis. He remained under total parenteral nutrition for 29 days post transplant, then oral intake was introduced and by the day 40 he was a full oral nutrition.

Serial endoscopies and biopsies were performed during the weeks after transplantation. Finally at day 68 the patient dies due to acute severe rejection.

Palavras-chave : Transplant; small bowel; immunosuppression; Costa Rica.

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